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NPI Code Detail

MEDICARE: ANDRIA BURGOON LIMHP

MEDICARE:   ANDRIA  BURGOON  LIMHP
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
1104100000XSocial WorkerLSW.0009922400CO
2101YM0800XMental Health Counselor3935NE

General Provider Information

NPI Number : 1477714913
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDRIA BURGOON LIMHP
Provider Business Mailing Address
First Line : 1800 W PASEWALK AVE STE A
Second Line :
City : NORFOLK
State : NE
Zip : 68701-5657
Country : US
Telephone Number : 402-500-6870
Fax Number :
Provider Business Practice Location Address
First Line : 1800 W PASEWALK AVE STE A
Second Line :
City : NORFOLK
State : NE
Zip : 68701-5657
Country : US
Telephone Number : 402-500-6870
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2008
Last Update Date : 11/22/2024

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Directions to “ ANDRIA BURGOON LIMHP” Practice Location

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