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NPI Code Detail

MEDICARE: MISS LAUREN ASHLEY BURKHEAD CRNP

MEDICARE: MISS LAUREN ASHLEY BURKHEAD CRNP
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
1363LF0000XFamily Nurse PractitionerR158084MD

General Provider Information

NPI Number : 1295940443
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS LAUREN ASHLEY BURKHEAD CRNP
Provider Business Mailing Address
First Line : PO BOX 6725
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-0725
Country : US
Telephone Number : 888-808-6483
Fax Number : 888-721-8040
Provider Business Practice Location Address
First Line : 2114 GENERALS HWY
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-7488
Country : US
Telephone Number : 888-808-6483
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2007
Last Update Date : 02/09/2011

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