Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 2006025694 | MO |
NPI | 1033450697 |
---|---|
Provider Name | Mrs. Sarah K Burrus |
First Address | Warrenton, MO 63383-1065 |
Second Address | Warrenton, MO 63383-1065 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2013 |
Last Update Date | 02/10/2015 |