Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 5692P | KY |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 3005692 | KY |
NPI | 1003076274 |
---|---|
Provider Name | Mrs. Amy Lauran Burnett |
First Address | Lexington, KY 40536-4000 |
Second Address | Lexington, KY 40536-4000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2008 |
Last Update Date | 28/12/2012 |