Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 95005455 | CA |
N | 363LG0600X | Nurse Practitioner - Gerontology | 95005455 | CA |
NPI | 1033650189 |
---|---|
Provider Name | Mrs. Christine Danel Burman |
First Address | San Diego, CA 92127-5705 |
Second Address | Encinitas, CA 92024-5156 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2017 |
Last Update Date | 08/11/2021 |