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General NPI Number Information
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NPI Number | 1760848204
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Entity Type | Individual
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Provider Name | KENNETH S BURNETTE NP
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Gender | Male
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Dates
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Enumeration Date | 01/14/2016
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 2320 KNOB CREEK RD STE 404
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City | JOHNSON CITY
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State | TN
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Zip | 37604-2581
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Country | US
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Telephone | 423-661-7445
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Fax | 423-224-3709
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Provider Business Mailing Address
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Address Line | 509 MED TECH PKWY STE 100
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City | JOHNSON CITY
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State | TN
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Zip | 37604-2579
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Country | US
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Telephone | 423-952-2111
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Fax | 423-952-2175
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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 | 0024173331
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License Number State | VA
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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 | 71014917A
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License Number State | IN
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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 | 5017076
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0035716
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 198628
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 41.564483
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License Number State | IL
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.030704
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License Number State | IL
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Taxonomy #8
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2024004887
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License Number State | MO
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Taxonomy #9
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 20898
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License Number State | TN
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