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NPI Code Detail

MEDICARE: MRS. KIMBERLY ANN BURNHAM

MEDICARE: MRS. KIMBERLY ANN BURNHAM
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
1163WS0200XSchool Registered NurseRN076435AZ

General Provider Information

NPI Number : 1881749638
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIMBERLY ANN BURNHAM
Provider Business Mailing Address
First Line : 2550 E ELLIOT RD
Second Line :
City : GILBERT
State : AZ
Zip : 85234-1304
Country : US
Telephone Number : 480-892-2801
Fax Number : 480-926-3673
Provider Business Practice Location Address
First Line : 2550 E ELLIOT RD
Second Line :
City : GILBERT
State : AZ
Zip : 85234-1304
Country : US
Telephone Number : 480-892-2801
Fax Number : 480-926-3673
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. KIMBERLY ANN BURNHAM ” Practice Location

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