Healthcare Provider Details

I. General information

NPI: 1508550765
Provider Name (Legal Business Name): ANDREW BURBINE FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 06/08/2023
Certification Date: 06/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 BAKER AVE
WHITEFISH MT
59937-2901
US

IV. Provider business mailing address

27 RICK OSHAY WAY
WHITEFISH MT
59937-8537
US

V. Phone/Fax

Practice location:
  • Phone: 406-862-2515
  • Fax:
Mailing address:
  • Phone: 406-240-6671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNUR-APRN-LIC-216108
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: