Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | 209006305 | IL |
N | 363LC1500X | Nurse Practitioner - Community Health | A-087007 | IA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | A-087007 | IA |
NPI | 1669519377 |
---|---|
Provider Name | Cynthia M Burr |
First Address | Muscatine, IA 52761-3433 |
Second Address | Muscatine, IA 52761-3433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 15/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0400642 | (05) | IA |
1669519377 | (05) | IA |
I21672 | (02) | IA |