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NPI Code Detail

MEDICARE: LAURINE BURRER

MEDICARE:   LAURINE  BURRER
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
1164W00000XLicensed Practical NurseLP00019642WA

General Provider Information

NPI Number : 1063884534
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURINE BURRER
Provider Business Mailing Address
First Line : 2874 SE LUND AVE
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366
Country : US
Telephone Number : 360-710-7595
Fax Number :
Provider Business Practice Location Address
First Line : 2874 SE LUND AVE
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366
Country : US
Telephone Number : 360-710-7595
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2015
Last Update Date : 10/23/2015

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Directions to “ LAURINE BURRER ” Practice Location

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