MEDICARE: MRS. SARAH K BURRUS RN, CPNP-PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	2006025694	MO

General Provider Information

NPI Number	:	1033450697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARAH K BURRUS RN, CPNP-PC

Provider Business Mailing Address
First Line	:	511 ASHLAND AVE
Second Line	:
City	:	WARRENTON
State	:	MO
Zip	:	63383-1065
Country	:	US
Telephone Number	:	636-456-0572
Fax Number	:

Provider Business Practice Location Address
First Line	:	511 ASHLAND AVE
Second Line	:
City	:	WARRENTON
State	:	MO
Zip	:	63383-1065
Country	:	US
Telephone Number	:	636-456-0572
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2013
Last Update Date	:	10/02/2015

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