Jane L. Waterman MD
Full Name
Jane Lynn Waterman MD
NPI Number
1144272543
NPI Type
Individual Provider
Gender
Female
Enumeration Date
05/16/2006
Specialties
(Taxonomies)Code
207P00000X
207Q00000X
Primary Taxonomy
No
No
Licenses
State
Arizona
California
Maine
Vermont
License Number
21800
C51611
013878
042-0010248
Contact
Information
Purpose
Mailing
Location
Address
6235 GARFIELD RD
6235 GARFIELD RD
City
Wolcott
Wolcott
State
VT
VT
Postal Code
05680-4311
05680-4311
Country
US
US
Telephone Number
(802) 888-9280
(802) 888-9280
Identifiers
Identifier
00C516110
Identifier State
CA
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 07/08/2007