Healthcare Provider Details

I. General information

NPI: 1972254407
Provider Name (Legal Business Name): LAUREN MARIE BURCHETTE CNP ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2022
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date: 01/20/2022
Reactivation Date: 02/21/2022

III. Provider practice location address

400 E POLK ST
WASHINGTON IA
52353-1237
US

IV. Provider business mailing address

400 E POLK ST
WASHINGTON IA
52353-1237
US

V. Phone/Fax

Practice location:
  • Phone: 319-653-5481
  • Fax: 319-863-3963
Mailing address:
  • Phone: 319-653-5481
  • Fax: 319-863-3963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA166166
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number166166
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: