MEDICARE: MS. AMY JEAN BURNETT

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	171400000X	Health & Wellness Coach	FB9774894	FL

General Provider Information

NPI Number	:	1376492488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMY JEAN BURNETT

Provider Business Mailing Address
First Line	:	5736 DOBSON DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28311-3451
Country	:	US
Telephone Number	:	813-508-4105
Fax Number	:

Provider Business Practice Location Address
First Line	:	5736 DOBSON DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28311-3451
Country	:	US
Telephone Number	:	813-508-4105
Fax Number	:

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

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	01/23/2026

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