Provider Demographics
NPI:1699793851
Name:BURNETT, PATSY LYNNE (NP)
Entity type:Individual
Prefix:
First Name:PATSY
Middle Name:LYNNE
Last Name:BURNETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315A S 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN BOW
Mailing Address - State:NE
Mailing Address - Zip Code:68822-2006
Mailing Address - Country:US
Mailing Address - Phone:308-872-6198
Mailing Address - Fax:
Practice Address - Street 1:315A S 8TH AVE
Practice Address - Street 2:
Practice Address - City:BROKEN BOW
Practice Address - State:NE
Practice Address - Zip Code:68822-2006
Practice Address - Country:US
Practice Address - Phone:308-872-6198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEAPPLIED FOR363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health