Provider Demographics
NPI:1114675493
Name:BURR, MICHELE LYNNE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:LYNNE
Last Name:BURR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3507 S MERCY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-0441
Mailing Address - Country:US
Mailing Address - Phone:480-926-0644
Mailing Address - Fax:480-926-0645
Practice Address - Street 1:3507 S MERCY RD STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-0441
Practice Address - Country:US
Practice Address - Phone:480-926-0644
Practice Address - Fax:480-926-0645
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN085354163WP0200X
AZTEMP273901207Q00000X
AZAPRN273901207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No163WP0200XNursing Service ProvidersRegistered NursePediatrics