Provider Demographics
NPI:1932591658
Name:EVERETT, CARYN E (FNP)
Entity Type:Individual
Prefix:
First Name:CARYN
Middle Name:E
Last Name:EVERETT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CARYN
Other - Middle Name:E
Other - Last Name:MACDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:714 BREEZY HILL RD
Mailing Address - Street 2:NVRH KINGDOM INTERNAL MEDICINE
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-8882
Mailing Address - Country:US
Mailing Address - Phone:802-748-7500
Mailing Address - Fax:802-745-1188
Practice Address - Street 1:714 BREEZY HILL RD
Practice Address - Street 2:NVRH KINGDOM INTERNAL MEDICINE
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-8882
Practice Address - Country:US
Practice Address - Phone:802-748-7500
Practice Address - Fax:802-745-1188
Is Sole Proprietor?:No
Enumeration Date:2015-03-04
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0110192363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily