Provider Demographics
NPI:1073986436
Name:BURNHAM, SHAYLYN RHAE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SHAYLYN
Middle Name:RHAE
Last Name:BURNHAM
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14909 SPILLMAN RANCH LOOP
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-6551
Mailing Address - Country:US
Mailing Address - Phone:325-226-3242
Mailing Address - Fax:
Practice Address - Street 1:2860 CREEKSIDE CIR
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8442
Practice Address - Country:US
Practice Address - Phone:541-779-8367
Practice Address - Fax:541-779-7471
Is Sole Proprietor?:No
Enumeration Date:2015-11-07
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129491363LF0000X
OR202000950NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily