MEDICARE: CHERYL R BURR RN/NP

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	101YM0800X	Mental Health Counselor	109412	CO

General Provider Information

NPI Number	:	1396998746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL R BURR RN/NP

Provider Business Mailing Address
First Line	:	7517 CAMPSTOOL DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80922-4626
Country	:	US
Telephone Number	:	719-447-0837
Fax Number	:

Provider Business Practice Location Address
First Line	:	7517 CAMPSTOOL DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80922-4626
Country	:	US
Telephone Number	:	719-447-0837
Fax Number	:

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

Provider Enumeration Date	:	10/29/2008
Last Update Date	:	11/11/2008

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