Doctor Name: | AMY JOY BURRELL |
NPI Number: | 1053718585 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | R192453 |
Business Practice Address: | 2360 W Joppa Rd Suite 210 Lutherville, MD - 210934624 |
Business Phone Number: | 4105832890 |
Business Fax Number: | 4105832891 |
Mailing Address: | 2360 W Joppa Rd, Suite 210 LUTHERVILLE |
State: | MD |
Postal Code: | 210934624 |
Phone Number: | 4105832890 |
Fax Number: | 4105832891 |
NPI Enumeration Date: | 11/26/2014 |
NPI Last Update Date: | 11/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R192453 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |