Provider Demographics
NPI:1104594720
Name:BURNHAM, VANESSA SUE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:SUE
Last Name:BURNHAM
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:VANESSA
Other - Middle Name:SUE
Other - Last Name:PAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:221 E HAMPDEN AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2620
Mailing Address - Country:US
Mailing Address - Phone:303-789-2251
Mailing Address - Fax:303-789-2505
Practice Address - Street 1:221 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2620
Practice Address - Country:US
Practice Address - Phone:303-789-2251
Practice Address - Fax:303-789-2505
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996892-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily