Healthcare Provider Details

I. General information

NPI: 1164139945
Provider Name (Legal Business Name): MARCI ELIZABETH BURCHFIELD APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2022
Last Update Date: 11/01/2022
Certification Date: 10/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 INDIANA AVE
LUBBOCK TX
79415-3364
US

IV. Provider business mailing address

5712 117TH ST
LUBBOCK TX
79424-7794
US

V. Phone/Fax

Practice location:
  • Phone: 806-775-8200
  • Fax:
Mailing address:
  • Phone: 806-392-6352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10910206
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: