Burnham, Vicki J

Burnham, Vicki J is an sole proprietor health care provider with primary practice located at 600 E Dixie Ave , Leesburg FL 34748-5925. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Burnham, Vicki J can be contacted via phone (352) 323-5762.

Contact Information

Primary practice address
600 E Dixie Ave Leesburg FL 34748-5925
Phone: (352) 323-5762
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP9188221 Florida

Profile Details

NPI number 1376582940
LBN Legal business name Burnham, Vicki J
Credentials ARNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 6th, 2006
Last updated May 20th, 2008 - about 16 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 1376582940 NPPES
Florida MEDICAID 304948500

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