NPI 1063850915

Warren M Fenner, PAC

Practitioner Physician Assistant Springfield, VT

Practice location

Address: 25 Ridgewood Rd Emergency Department, Springfield, VT 05156-3050
Phone: (802) 885-2151

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 055-0031215 (VT)

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Registry record

NPI: 1063850915
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Jun 2013
Record last updated: 12 Aug 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.