NPI 1154509404 · live from the CMS NPI Registry
Kaitlin E Brenny, PA-C
Physician Assistant in Fairfax, VT. National Provider Identifier 1154509404, active.
NPI record
| NPI | 1154509404 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 4178 Highbridge Rd, Fairfax, VT 05454 |
| Practice phone | 802-582-2600 |
| Mailing address | 44 Main St Ste 200, Richford, VT 05476 |
| Enumerated | February 7, 2008 |
| Last updated | January 15, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | 055-0030917 (VT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.