Provider Demographics
NPI:1144326182
Name:FRANCIS, MARY ANN (MSN, APRN)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:ANN
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:MSN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 MAHONEY AVE
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4836
Mailing Address - Country:US
Mailing Address - Phone:802-236-4596
Mailing Address - Fax:
Practice Address - Street 1:3400 HEALDVILLE RD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:VT
Practice Address - Zip Code:05730
Practice Address - Country:US
Practice Address - Phone:802-236-4596
Practice Address - Fax:802-773-2496
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1010017594101YM0800X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN1007Medicaid
VTFRVN1007Medicare ID - Type Unspecified