person
Bethany Lynn Stack, PA
Medical Physician Assistant in Rutland, Vermont
NPI 1184619876

Bethany Lynn Stack is a Medical Physician Assistant based in Rutland, VT and is specialized in Medical. Bethany Lynn Stack practices in Rutland, VT and has the professional credentials of PA. The NPI Number for Bethany Lynn Stack is 1184619876 and holds a License No. 055-0030670 (Vermont).

The current practice location address for Bethany Lynn Stack is 3 Albert Cree Dr, Rutland, VT and can be reached out via phone at 802-775-2937 and via fax at 802-773-0934.

Location: 3 Albert Cree Dr, Rutland, VT, 05701-4601
person
Provider Profile Details
NPI Number
1184619876
Provider Name
Bethany Lynn Stack
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
3 Albert Cree Dr, Rutland, VT, 05701-4601
Phone Number
802-775-2937
Fax Number
802-773-0934
Provider Enumeration Date
09/19/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00059907 01 VT BCBS
institution
Provider Business Practice Location Address Details
Address
3 Albert Cree Dr
City
State
Zip
05701-4601
Phone Number
802-775-2937
Fax Number
802-773-0934
person
Provider Business Mailing Address Details
Address
3 Albert Cree Dr
City
State
Zip
05701-4601
Phone Number
802-775-2937
Fax Number
802-773-0934
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
055-0030670 (Vermont)
Definition
Definition to come...
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