MEDICARE: NATALIE BURNETT NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	F309201	NY
2	163W00000X	Registered Nurse	582510	NY

General Provider Information

NPI Number	:	1043520422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE BURNETT NP

Provider Business Mailing Address
First Line	:	1 MYRTLE LN
Second Line	:
City	:	EAST PATCHOGUE
State	:	NY
Zip	:	11772-5722
Country	:	US
Telephone Number	:	631-356-6766
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 MYRTLE LN
Second Line	:
City	:	EAST PATCHOGUE
State	:	NY
Zip	:	11772-5722
Country	:	US
Telephone Number	:	631-356-6766
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2010
Last Update Date	:	03/09/2020

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