Healthcare Provider Details

I. General information

NPI: 1508842709
Provider Name (Legal Business Name): JAMI DALTON RNCSFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JAMI BURLINGAME RNCSFNP

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 05/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N ADAMS ST
MEMPHIS MO
63555-1605
US

IV. Provider business mailing address

607 BIG HORN DR
O FALLON MO
63368-6944
US

V. Phone/Fax

Practice location:
  • Phone: 660-465-7455
  • Fax:
Mailing address:
  • Phone: 660-341-6289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number143209
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: