KELLY BRUSH DAVISSON (NPI# 1730518549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730518549 |
| Entity Type | Individual |
| Full Name | KELLY BRUSH DAVISSON |
| Practice Address |
128 Lakeside Ave Ste 115 Burlington VT 05401 |
| Mailing Address |
128 Lakeside Ave Ste 115 Burlington VT 05401-4936 |
| Practice Telephone | 8028601928 |
| Practice Fax Number | 8028600192 |
| Mailing Telephone | 8028601928 |
| Mailing Fax Number | 8028600192 |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2019-03-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1010122886 | VT | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336455724 | Kelly D Davisson | Doula | 13401 N County Road 100 W, Muncie, IN 47303-9740 | 2010-08-24 |
| Street Address |
128 LAKESIDE AVE STE 115 |
| City | BURLINGTON |
| State | VT |
| Zip Code | 05401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932665684 | Kathleen Morwood Goodwin | Nurse Practitioner | 128 Lakeside Ave Ste 115, Burlington, VT 05401-4936 | 2019-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821626748 | John Henry Priester Jr. | Student in an Organized Health Care Education/Training Program | University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VT 05401 | 2020-03-27 |
| 1730649054 | Parisa Heidari | Student in an Organized Health Care Education/Training Program | Uvmmc 111 Colchester Avenue, Burlington, VT 05401 | 2019-03-22 |
| 1689141988 | No Diet Dietitian, LLC | Dietitian, Registered | 163 Bayberry Circle #204, Burlington, VT 05401 | 2018-10-25 |
| 1073097267 | Katherine Dwyer | Physical Therapist | 128 Lakeside Ave, Burlington, Vt, 05401, Burlington, VT 05401 | 2018-09-24 |
| 1710469481 | Nicholas A Fredette | Nurse Practitioner | 28 S. Williams St., Burlington, VT 05401 | 2018-08-30 |
| 1760987473 | Tyler Fanning | Psychiatry & Neurology | Uvmmv 111 Colchester Avenue, Burlington, VT 05401 | 2018-03-26 |
| 1356845416 | Rachel Carlson | Student in an Organized Health Care Education/Training Program | Uvmmc, 111 Colchester Avenue, Burlington, VT 05401 | 2018-03-22 |
| 1487152096 | Garnet Transport Medicine, LLC | Ambulance | 70 S Winooski Ave Ste 255, Burlington, VT 05401 | 2018-01-29 |
| 1689172660 | Valerie Goldberg | Dietitian, Registered | 163 Bayberry Circle Apt 204, Burlington, VT 05401 | 2018-01-25 |
| 1548774235 | Emily R Day | Physical Therapist | 160 Flynn Avenue, Burlington, VT 05401 | 2017-11-17 |
| Find all providers in zip 05401 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558988782 | Oshiokwueme Osilama | Nurse Practitioner | 11 Algonquin Dr, Burlington, MA 01803-3630 | 2020-07-03 |
| 1861053993 | Anjani Kumar Agarwala | Nurse Practitioner | 260 Winn St Apt B, Burlington, MA 01803-2636 | 2019-06-28 |
| 1720549637 | Sheri Soucy | Nurse Practitioner | 41 Mall Road 5 E Cardiology, Burlington, MA 01805-0001 | 2019-03-26 |
| 1225585573 | Kathleen Marie Ferrara | Nurse Practitioner | Walgreens Healthcare Clinic, 1747 Patrick Drive, Burlington, KY 41005 | 2016-09-03 |
| 1134525645 | Amy R Aeschliman | Nurse Practitioner | 425 E. 5th Street, Suite B, Burlington, IN 46915-1758 | 2014-11-10 |
| 1669888335 | Heide Wakefield-thorne | Nurse Practitioner | 37007 65th Ct, Burlington, WI 53105-8554 | 2014-07-02 |
| 1083806939 | Mary Katherine Mcneice | Nurse Practitioner | Lahey Clinic Medical Center - Medical Oncology, 41 Mall Rd, Burlington, MA 01805-0001 | 2007-08-14 |
| 1033317557 | Susan Marie Dorman | Nurse Practitioner | 291 15th St, Burlington, CO 80807-1619 | 2007-07-05 |
| 1467650184 | Hart Healthcare, Pllc | Nurse Practitioner | 4467 Hackberry Ct, Burlington, KY 41005-6904 | 2007-07-03 |
| 1790843233 | Kathryn Grace Rittenhouse | Nurse Practitioner | 1177 Rose Ave, Burlington, CO 80807-1756 | 2006-12-05 |
| Find all providers in BURLINGTON | ||||
| City | BURLINGTON |
| Zip Code | 05401 |
Please comment or provide details below to improve the information on KELLY BRUSH DAVISSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.