Provider Demographics
NPI:1932201043
Name:BURZYNSKI, ANN E (APRN)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:E
Last Name:BURZYNSKI
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:PO BOX 647
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05601-0647
Mailing Address - Country:US
Mailing Address - Phone:802-223-6328
Mailing Address - Fax:802-229-8004
Practice Address - Street 1:286 HOSPITAL LOOP
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9523
Practice Address - Country:US
Practice Address - Phone:802-229-0591
Practice Address - Fax:802-223-3667
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0035775364SP0809X
VT101-0035775163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT989026BOtherMVP HEALTHCARE
VTP00448714OtherMEDICARE RAILROAD
VT2208214OtherCIGNA
VT1014128Medicaid
1932201043OtherBLUE CROSS/BLUE SHIELD OF VERMONT
VT405739OtherMHN TRICARE
VT2208214OtherCIGNA
VT1014128Medicaid