Healthcare Provider Details

I. General information

NPI: 1639261746
Provider Name (Legal Business Name): JULIE MARIE BURROWES PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

562 WEST 2ND AVENUE
LITITZ PA
17543-1816
US

IV. Provider business mailing address

201 ROCK LILITZ BLVD POD 2, STE 14
LITITZ PA
17543-8781
US

V. Phone/Fax

Practice location:
  • Phone: 717-517-0736
  • Fax: 717-295-3014
Mailing address:
  • Phone: 717-517-0736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA003381L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: