Lisa Kelley, CNM | |
1775 Williston Rd, Suite 220, South Burlington, VT 05403-6491 | |
(802) 861-0200 | |
(802) 861-0210 |
Full Name | Lisa Kelley |
---|---|
Gender | Female |
Speciality | Advanced Practice Midwife |
Location | 1775 Williston Rd, South Burlington, Vermont |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1447237516 | NPI | - | NPPES |
361683 | Other | VT | MVP |
5207602 | Other | VT | VERMONT MANAGED CARE |
00059280 | Other | VT | BCBS |
1009149 | Medicaid | VT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367A00000X | Advanced Practice Midwife | 101-0014084 (Vermont) | Primary |
Entity Name | Vermont Gynecology Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174830251 PECOS PAC ID: 0244428357 Enrollment ID: O20101215001181 |
Mailing Address | Practice Location Address |
---|---|
Lisa Kelley, CNM 66 Bartlett Bay Rd, South Burlington, VT 05403-7737 Ph: (802) 777-8997 | Lisa Kelley, CNM 1775 Williston Rd, Suite 220, South Burlington, VT 05403-6491 Ph: (802) 861-0200 |
Emily Ruth Gates Olson, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 185 Tilley Dr Ste 57, South Burlington, VT 05403 Phone: 802-862-7338 | |
Leah Starr, Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 185 Tilley Dr, South Burlington, VT 05403 Phone: 802-862-7338 Fax: 802-862-8411 |