Healthcare Provider Details

I. General information

NPI: 1639254386
Provider Name (Legal Business Name): KAREN BURNETT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 W 92ND PL SUITE 104
WESTMINSTER CO
80031-2798
US

IV. Provider business mailing address

WEST 92ND AVE SUITE 104
WESTMINSTER CO
80031
US

V. Phone/Fax

Practice location:
  • Phone: 303-429-6600
  • Fax: 303-429-6601
Mailing address:
  • Phone: 303-429-6600
  • Fax: 303-429-6601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number45874
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: