Provider Demographics
NPI:1104958891
Name:BURDENIUK, ROBBIE W (CRNFA)
Entity type:Individual
Prefix:MR
First Name:ROBBIE
Middle Name:W
Last Name:BURDENIUK
Suffix:
Gender:M
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1750
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-1750
Mailing Address - Country:US
Mailing Address - Phone:512-858-1575
Mailing Address - Fax:512-858-1804
Practice Address - Street 1:188 SOUTHERN SUNSET CV
Practice Address - Street 2:
Practice Address - City:DRIFTWOOD
Practice Address - State:TX
Practice Address - Zip Code:78619-1501
Practice Address - Country:US
Practice Address - Phone:512-858-1575
Practice Address - Fax:512-858-1804
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000098744163WR0006X
TX790514163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant