Provider Demographics
NPI:1902171549
Name:ETHERINGTON, ANN EVELYN (RN)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:EVELYN
Last Name:ETHERINGTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 HOLLOW CREEK DR UNIT 1
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-7133
Mailing Address - Country:US
Mailing Address - Phone:802-999-4837
Mailing Address - Fax:
Practice Address - Street 1:199 HOLLOW CREEK DR UNIT 1
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-7133
Practice Address - Country:US
Practice Address - Phone:802-999-4837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026.0039039163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse