MEDICARE: MRS. LAURA N BURR APRN

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	363LF0000X	Family Nurse Practitioner	001471	CT

General Provider Information

NPI Number	:	1053323998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAURA N BURR APRN

Provider Business Mailing Address
First Line	:	145 LONGDEAN RD
Second Line	:
City	:	FAIRFIELD
State	:	CT
Zip	:	06824-6533
Country	:	US
Telephone Number	:	203-254-0948
Fax Number	:

Provider Business Practice Location Address
First Line	:	2184 MAIN ST
Second Line	:
City	:	STRATFORD
State	:	CT
Zip	:	06615-5937
Country	:	US
Telephone Number	:	203-378-9002
Fax Number	:

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

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	07/08/2007

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