Provider Demographics
NPI:1780300202
Name:KOBYLENSKI SANDERSON, ANN
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:KOBYLENSKI SANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:KOBYLENSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 108
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:VT
Mailing Address - Zip Code:05062-0108
Mailing Address - Country:US
Mailing Address - Phone:802-345-0801
Mailing Address - Fax:
Practice Address - Street 1:756 BROWN SCHOOLHOUSE RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:VT
Practice Address - Zip Code:05062
Practice Address - Country:US
Practice Address - Phone:802-345-0801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026.0135714163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical