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General NPI Number Information
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NPI Number | 1023202017
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Entity Type | Individual
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Provider Name | CHERYL A BURLETT M.S. PHARM
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Gender | Female
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Dates
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Enumeration Date | 09/01/2007
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 3695 HOT SPRINGS BLVD
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City | LAS VEGAS
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State | NM
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Zip | 87701-9549
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Country | US
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Telephone | 505-454-2183
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Fax | 505-454-2182
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Provider Business Mailing Address
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Address Line | 3695 HOT SPRINGS BLVD
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City | LAS VEGAS
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State | NM
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Zip | 87701-9549
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Country | US
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Telephone | 505-454-2183
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Fax | 505-454-2182
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | RP00004930
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | PC00000054
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License Number State | NM
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