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General NPI Number Information
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NPI Number | 1891378501
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Entity Type | Individual
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Provider Name | CARRIE LYNN BURDEN MS, CNS, LDN
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Gender | Female
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Dates
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Enumeration Date | 04/30/2021
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Last Update Date | 04/30/2021
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Provider Practice Location Address
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Address Line | 300 BROOKSIDE AVE STE 180
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City | AMBLER
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State | PA
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Zip | 19002-3436
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Country | US
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Telephone | 484-416-4189
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Fax |
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Provider Business Mailing Address
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Address Line | 1419 NEWMAN RD
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City | PENNSBURG
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State | PA
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Zip | 18073-1925
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Country | US
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Telephone | 267-328-7642
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | DN007281
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License Number State | PA
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