NPI Code Detail JSON Logo

1588904031 NPI number — LAURIE JENAY BURNWORTH PA-C

NPI Number: 1588904031
Health Care Provider/Practitioner: LAURIE JENAY BURNWORTH PA-C

Information about “1588904031” NPI (LAURIE JENAY BURNWORTH PA-C) exists in 1588904031 in HTML format HTML  |  1588904031 in plain Text format TXT  |  1588904031 in PDF (Portable Document Format) PDF  |  1588904031 in an XML format XML  formats.

NPI Number : 1588904031 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1588904031",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BURNWORTH",
    "FirstName": "LAURIE",
    "MiddleName": "JENAY",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "PA-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SILICATO",
    "OtherFirstName": "LAURIE",
    "OtherMiddleName": "J",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PA-C",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 33269",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PHOENIX",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85067-3269",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "602-406-4786",
    "MailingAddressFaxNumber": "916-636-4358",
    "FirstLinePracticeLocationAddress": "20715 E OCOTILLO RD STE 102",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "QUEEN CREEK",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85142-6118",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "480-877-0901",
    "PracticeLocationAddressFaxNumber": "480-987-0940",
    "EnumerationDate": "02/20/2013",
    "LastUpdateDate": "09/10/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "6759",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363AM0700X",
          "TaxonomyName": "Medical Physician Assistant",
          "LicenseNumber": "6759",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2025 Data Labs Health. All rights reserved.