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General NPI Number Information
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NPI Number | 1215186028
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Entity Type | Individual
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Provider Name | JAMES L BURRELL JR. CFNP
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Gender | Male
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Dates
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Enumeration Date | 09/17/2008
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Last Update Date | 11/24/2009
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Provider Practice Location Address
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Address Line | 2885 MCCULLOUGH BLVD
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City | BELDEN
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State | MS
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Zip | 38826
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Country | US
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Telephone | 662-566-5593
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Fax | 662-566-4419
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Provider Business Mailing Address
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Address Line | PO BOX 353
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City | BELDEN
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State | MS
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Zip | 38826-0353
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Country | US
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Telephone | 662-566-5593
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Fax | 662-566-4419
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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 | R866565
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License Number State | MS
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