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General NPI Number Information
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NPI Number | 1598684896
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Entity Type | Individual
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Provider Name | BIANCA BURNETT
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Gender | Female
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Dates
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Enumeration Date | 07/13/2026
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | 12173 MAIN ST STE B
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City | MASON
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State | TN
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Zip | 38049-7067
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Country | US
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Telephone | 901-403-8432
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Fax |
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Provider Business Mailing Address
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Address Line | 6000 POPLAR AVE
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City | MEMPHIS
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State | TN
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Zip | 38119-3981
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Country | US
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Telephone | 901-606-4634
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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 | 41971
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License Number State | TN
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