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NPI 1801123229

NPI 1801123229 : ERICA BURGETT FNP : AUSTIN, TX

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General NPI Number Information
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    NPI Number           |    1801123229
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    Entity Type          |    Individual 
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    Provider Name        |    ERICA BURGETT FNP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/05/2009
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    Last Update Date     |    05/20/2016
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Provider Practice Location Address
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    Address Line         |    2911 MEDICAL ARTS ST BUILDING 10
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78705-3376
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    Country              |    US
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    Telephone            |    512-477-1405
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5111 AVENUE H 
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78751-2025
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    Country              |    US
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    Telephone            |    512-567-5396
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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       |    794225
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    License Number State |    TX
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