Provider Demographics
NPI:1477501583
Name:BURNS, ELIZABETH HELEN (ANP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:HELEN
Last Name:BURNS
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 CROSS PKWY
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-5711
Mailing Address - Country:US
Mailing Address - Phone:802-847-2345
Mailing Address - Fax:802-847-8232
Practice Address - Street 1:FLETCHER ALLEN HEALTH CARE
Practice Address - Street 2:111 COLCHESTER AVE
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401
Practice Address - Country:US
Practice Address - Phone:802-847-3979
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT9636363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1009963Medicaid
VT1009963Medicaid
VTQ05335Medicare UPIN