Provider Demographics
NPI:1194368464
Name:BURNETT LIPSCOMB, HEATHER LEE (CRNP, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LEE
Last Name:BURNETT LIPSCOMB
Suffix:
Gender:F
Credentials:CRNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 LEGACY DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35146-2703
Mailing Address - Country:US
Mailing Address - Phone:205-473-1841
Mailing Address - Fax:
Practice Address - Street 1:2000 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-2110
Practice Address - Country:US
Practice Address - Phone:205-801-7432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-19
Last Update Date:2019-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-157811363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily