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NPI Code Detail

MEDICARE: MS. LILLIE BURNETT APRN, BC

MEDICARE:  MS. LILLIE  BURNETT  APRN, BC
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
1364SP0809XAdult Psychiatric/Mental Health Clinical Nurse SpecialistRN063097GA

General Provider Information

NPI Number : 1821070020
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LILLIE BURNETT APRN, BC
Provider Business Mailing Address
First Line : 2540 WINDY HILL RD SE
Second Line :
City : MARIETTA
State : GA
Zip : 30067-8605
Country : US
Telephone Number : 770-644-1570
Fax Number : 770-644-1576
Provider Business Practice Location Address
First Line : 450 NORTHSIDE CHEROKEE BLVD
Second Line :
City : CANTON
State : GA
Zip : 30115-8015
Country : US
Telephone Number : 770-224-1000
Fax Number : 770-224-2451
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2005
Last Update Date : 03/05/2018

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Directions to “ MS. LILLIE BURNETT APRN, BC” Practice Location

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