Provider Demographics
NPI:1043544430
Name:BURLEY, DEBORAH LYNNE (FNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYNNE
Last Name:BURLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 LANDA
Mailing Address - Street 2:SUITE C
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-6163
Mailing Address - Country:US
Mailing Address - Phone:830-629-3614
Mailing Address - Fax:830-629-2438
Practice Address - Street 1:705 LANDA
Practice Address - Street 2:SUITE C
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-6163
Practice Address - Country:US
Practice Address - Phone:830-629-3614
Practice Address - Fax:830-629-2438
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX591581363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX310114901Medicaid