| Doctor Name: | KATHLEEN JACKMAN |
| NPI Number: | 1902844004 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 1010026217 |
| Business Practice Address: | 156 Main St Montpelier, VT - 056022702 |
| Business Phone Number: | 8022234738 |
| Business Fax Number: | 8022236067 |
| Mailing Address: | Po Box 547, Central Vermont Medical Center - Finance Dept BARRE |
| State: | VT |
| Postal Code: | 056410547 |
| Phone Number: | 8022234738 |
| Fax Number: | 8022236067 |
| NPI Enumeration Date: | 06/02/2006 |
| NPI Last Update Date: | 12/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 1010026217 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |