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General NPI Number Information
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NPI Number | 1447488788
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Entity Type | Individual
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Provider Name | BRENNA MCCARTNEY BURNETTE CRNA
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Gender | Female
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Dates
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Enumeration Date | 06/25/2009
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 1139 GRANT ST
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City | LONGMONT
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State | CO
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Zip | 80501-3707
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Country | US
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Telephone | 919-698-3960
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Fax |
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Provider Business Mailing Address
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Address Line | 1139 GRANT ST STE 300
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City | LONGMONT
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State | CO
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Zip | 80501-3707
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Country | US
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Telephone | 919-698-3960
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Fax | 828-274-7407
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 196402
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 082163
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APN.0996116-CRNA
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License Number State | CO
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