MEDICARE: AMBER DAWN BURDETTE

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	363LA2200X	Adult Health Nurse Practitioner	228655	OK

General Provider Information

NPI Number	:	1417880667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER DAWN BURDETTE

Provider Business Mailing Address
First Line	:	9408 E 117TH ST S
Second Line	:
City	:	BIXBY
State	:	OK
Zip	:	74008-1810
Country	:	US
Telephone Number	:	918-527-6001
Fax Number	:

Provider Business Practice Location Address
First Line	:	9408 E 117TH ST S
Second Line	:
City	:	BIXBY
State	:	OK
Zip	:	74008-1810
Country	:	US
Telephone Number	:	918-527-6001
Fax Number	:

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

Provider Enumeration Date	:	06/06/2026
Last Update Date	:	06/06/2026

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Directions to “ AMBER DAWN BURDETTE ” Practice Location

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