Female

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

Provider Address