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General NPI Number Information
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NPI Number | 1639489966
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Entity Type | Individual
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Provider Name | ELIZABETH DAWN BURNETTE FNP
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Gender | Female
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Dates
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Enumeration Date | 10/20/2010
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 3918 BISHOP RD
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-2780
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Country | US
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Telephone | 252-299-0057
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Fax | 252-673-2518
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Provider Business Mailing Address
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Address Line | 3918 BISHOP RD
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-2248
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Country | US
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Telephone | 252-299-0057
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Fax | 252-673-2518
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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 | 25360
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License Number State | MT
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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 | 25360
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5010656
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License Number State | NC
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