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General NPI Number Information
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NPI Number | 1437741444
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Entity Type | Individual
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Provider Name | KATIE MOORE BURNETT APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/10/2021
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 350G RACETRACK RD NW
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-1699
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Country | US
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Telephone | 850-374-3125
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Fax | 850-226-5544
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Provider Business Mailing Address
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Address Line | 307 BOATNER RD STE 114
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City | EGLIN AFB
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State | FL
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Zip | 32542-1302
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Country | US
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Telephone | 850-883-8180
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Fax | 850-279-3312
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11012193
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11012193
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9462666
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License Number State | FL
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