Provider Demographics
NPI:1154809184
Name:BURNETT, ANGELA MARIE (APRN)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:MARIE
Last Name:BURNETT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 DW HWY
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-5256
Mailing Address - Country:US
Mailing Address - Phone:603-891-4500
Mailing Address - Fax:603-891-4452
Practice Address - Street 1:208 ROBINSON RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-3059
Practice Address - Country:US
Practice Address - Phone:603-882-6700
Practice Address - Fax:603-598-6440
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH058228-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily