Doctor Name: | JANA JOEL MCBURNEY |
NPI Number: | 1508100207 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | 4704201690 |
Business Practice Address: | 280 1st St Holloman Afb, NM - 883308273 |
Business Phone Number: | 5755723041 |
Business Fax Number: | 5755722259 |
Mailing Address: | 280 1st St, HOLLOMAN AFB |
State: | NM |
Postal Code: | 883308273 |
Phone Number: | 5755723041 |
Fax Number: | 5755722259 |
NPI Enumeration Date: | 11/19/2012 |
NPI Last Update Date: | 07/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 4704201690 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |