| Doctor Name: | MICHELLE E BURNHAM |
| NPI Number: | 1275781254 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 155361 |
| Business Practice Address: | 402 Main St Van Buren, MO - 639650000 |
| Business Phone Number: | 5733234253 |
| Business Fax Number: | 5733234465 |
| Mailing Address: | Po Box 157, ELLINGTON |
| State: | MO |
| Postal Code: | 636380157 |
| Phone Number: | 5736632313 |
| Fax Number: | 5736632322 |
| NPI Enumeration Date: | 09/03/2008 |
| NPI Last Update Date: | 03/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 155361 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |