Provider Demographics
NPI:1528327764
Name:CLEMENTE, KATHERINE FRANCES (PA)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:FRANCES
Last Name:CLEMENTE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:165 SHERMAN DR
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-9811
Mailing Address - Country:US
Mailing Address - Phone:802-748-9405
Mailing Address - Fax:802-748-4540
Practice Address - Street 1:6 SAN REMO DR
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6310
Practice Address - Country:US
Practice Address - Phone:802-862-3983
Practice Address - Fax:802-863-7994
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2017-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VT055.0031130363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical