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General NPI Number Information
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NPI Number | 1780159624
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Entity Type | Individual
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Provider Name | TERESA ELAINE BURNETT
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Gender | Female
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Dates
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Enumeration Date | 10/08/2018
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 316 WARREN AVE STE 1
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City | FRONT ROYAL
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State | VA
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Zip | 22630-4480
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Country | US
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Telephone | 540-456-2460
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Fax |
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Provider Business Mailing Address
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Address Line | 279 ALEXANDRIA PIKE
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City | WARRENTON
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State | VA
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Zip | 20186-2939
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Country | US
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Telephone | 540-497-1454
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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 | 0024176710
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License Number State | VA
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