Healthcare Provider Details

I. General information

NPI: 1033650189
Provider Name (Legal Business Name): CHRISTINE DANEL BURMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2017
Last Update Date: 11/08/2021
Certification Date: 11/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 SANTA FE DR
ENCINITAS CA
92024-5156
US

IV. Provider business mailing address

10790 RANCHO BERNARDO RD MAIL DROP 4S-205
SAN DIEGO CA
92127-5705
US

V. Phone/Fax

Practice location:
  • Phone: 760-633-7240
  • Fax: 760-633-6921
Mailing address:
  • Phone: 760-633-7240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number95005455
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95005455
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: