MEDICARE: TERESA K BURNAP D.P.M.

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	213ES0103X	Foot & Ankle Surgery Podiatrist	238	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	27-00188	OTHER	NE	UNITED HEALTHCARE ID
3	2587	OTHER	NE	BLUE CROSS BLUE SHIELD ID

General Provider Information

NPI Number	:	1821091638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA K BURNAP D.P.M.

Provider Business Mailing Address
First Line	:	1150 N 83RD ST
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68505-2080
Country	:	US
Telephone Number	:	402-483-4485
Fax Number	:	402-483-5372

Provider Business Practice Location Address
First Line	:	1150 N 83RD ST
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68505-2080
Country	:	US
Telephone Number	:	402-483-4485
Fax Number	:	402-483-5372

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	01/18/2008

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