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General NPI Number Information
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NPI Number | 1134502792
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Entity Type | Individual
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Provider Name | STEVIE BURNEY
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Gender | Female
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Dates
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Enumeration Date | 07/01/2015
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 808 JOHNSON ST
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City | TALLULAH
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State | LA
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Zip | 71282-4535
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Country | US
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Telephone | 318-574-5080
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Fax | 318-574-3805
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Provider Business Mailing Address
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Address Line | 300 S PARK RD SUITE 400
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City | HOLLYWOOD
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State | FL
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Zip | 33021-8593
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Country | US
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Telephone |
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP09540
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R883041
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License Number State | MS
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