MEDICARE: RUBY BURMA MSN, PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	248913	AK

General Provider Information

NPI Number	:	1174481097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUBY BURMA MSN, PMHNP

Provider Business Mailing Address
First Line	:	5841 BIG BEND LOOP
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99502-4053
Country	:	US
Telephone Number	:	443-831-0165
Fax Number	:

Provider Business Practice Location Address
First Line	:	5841 BIG BEND LOOP
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99502-4053
Country	:	US
Telephone Number	:	443-831-0165
Fax Number	:

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

Provider Enumeration Date	:	01/10/2026
Last Update Date	:	01/10/2026

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