Burnett, Amanda Verkruissen

Burnett, Amanda Verkruissen is an individual health care provider with primary practice located at 1717 Oak Park Blvd Fl 1 , Lake Charles LA 70601-8977. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Burnett, Amanda Verkruissen can be contacted via phone (337) 494-6800.

Contact Information

Primary practice address
1717 Oak Park Blvd Fl 1 Lake Charles LA 70601-8977
Fax: (337) 494-6761
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X AP0071 Louisiana

Profile Details

NPI number 1235452822
LBN Legal business name Burnett, Amanda Verkruissen
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 10th, 2010
Last updated Apr 27th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235452822 NPPES
Louisiana Other AP0071 STATE MEDICAL LICENSE
Louisiana MEDICAID 2102605 STATE MEDICAL LICENSE

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