Lynne L Colville, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

101-0011925 Issued in VT

Practice address

275 Route 30 N
Bomoseen, VT 05732-9647

Phone

(802) 468-5641

Fax

(802) 468-2923

NPI assigned

Apr 24, 2007

Last updated

Aug 30, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1174741912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 ROUTE 30 N",
            "city": "BOMOSEEN",
            "state": "VT",
            "postal_code": "057329647",
            "telephone_number": "802-468-5641",
            "fax_number": "802-468-2923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 ROUTE 30 N",
            "city": "BOMOSEEN",
            "state": "VT",
            "postal_code": "057329647",
            "telephone_number": "802-468-5641",
            "fax_number": "802-468-2923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLVILLE",
        "first_name": "LYNNE",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VT",
            "license": "101-0011925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0NS2006",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley Alan Berryhill, MD
• Deborah A Bethel, APRN
• Edward William Brown, DC
• Samuel Joseph Cahill, PA-C
• Julia Carone, MS,RD
• Community Health Centers of the Rutland Region, Inc.
• Tammy Ann Delbianco, RPH.
• Hans Peter Diercksen, MD
• Maria Grace Durkee, MS, RDN, CD
• Sarah Hart Dwyer, APRN

• Psychiatric/Mental Health Nurse Practitioner in Bomoseen, VT
• Providers in Bomoseen, VT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.