Healthcare Provider Details

I. General information

NPI: 1932201043
Provider Name (Legal Business Name): ANN E. BURZYNSKI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 06/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

286 HOSPITAL LOOP
BERLIN VT
05602-9523
US

IV. Provider business mailing address

PO BOX 647
MONTPELIER VT
05601-0647
US

V. Phone/Fax

Practice location:
  • Phone: 802-229-0591
  • Fax: 802-223-3667
Mailing address:
  • Phone: 802-223-6328
  • Fax: 802-229-8004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number101.0035775
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number101-0035775
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: