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General NPI Number Information
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NPI Number | 1093510158
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Entity Type | Organization
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Legal Business Name | BURD MENTAL HEALTH LLC
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 65 WINGED ELM CT
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-3547
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Country | US
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Telephone | 904-902-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 52 TUSCAN WAY STE 202 - 353
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City | ST. AUGUSTINE
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State | FL
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Zip | 32092
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Country | US
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Telephone | 904-902-1234
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LINDSEY BURD
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Credential | PMHNP
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Telephone | 904-902-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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