Healthcare Provider Details

I. General information

NPI: 1801790548
Provider Name (Legal Business Name): AMY DARBY BURNETT CSFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 MOREHEAD MEDICAL DR STE 600
CHARLOTTE NC
28204-2969
US

IV. Provider business mailing address

1350 S KINGS DR, CHARLOTTE, NC 28207
CHARLOTTE NC
28207
US

V. Phone/Fax

Practice location:
  • Phone: 704-355-6649
  • Fax:
Mailing address:
  • Phone: 704-355-6649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: