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General NPI Number Information
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NPI Number | 1851439368
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Entity Type | Individual
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Provider Name | MAUREEN BURNISTON RN
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 10/15/2012
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Provider Practice Location Address
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Address Line | 1233 SOUTHWEST AVE EXTENSION
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City | JOHNSON CITY
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State | TN
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Zip | 37604-6519
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Country | US
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Telephone | 423-979-4626
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Fax | 423-979-3267
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Provider Business Mailing Address
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Address Line | 1167 DRY HILL RD
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City | BUTLER
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State | TN
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Zip | 37640-7341
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Country | US
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Telephone | 423-768-3226
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Fax | 423-768-2501
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | RN0000056949
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License Number State | TN
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