=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790624153
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MR. KALEN WHITTAKER BURWELL
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/27/2026
-----------------------------------------------------
Last Update Date | 03/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 80 VETERANS BLVD
-----------------------------------------------------
City | BRYSON CITY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28713-8816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-538-4546
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 514 COAPMAN ST APT 2F
-----------------------------------------------------
City | GREENSBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27407-1841
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 5023555
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------