| Doctor Name: | JEWEL D BURDEN |
| NPI Number: | 1073996070 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 0110005096 |
| Business Practice Address: | 4092 Foxwood Dr Ste 101 Va Beach, VA - 234625225 |
| Business Phone Number: | 7576863525 |
| Business Fax Number: | 7576860541 |
| Mailing Address: | Po Box 7549, PORTSMOUTH |
| State: | VA |
| Postal Code: | 237070549 |
| Phone Number: | 7576863525 |
| Fax Number: | 7576860541 |
| NPI Enumeration Date: | 07/08/2015 |
| NPI Last Update Date: | 02/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 0110005096 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |