Provider Demographics
NPI:1508519000
Name:BURCHETT, CEIARA (FNP)
Entity Type:Individual
Prefix:
First Name:CEIARA
Middle Name:
Last Name:BURCHETT
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 1:201 MORGAN BELL CIR
Mailing Address - Street 2:
Mailing Address - City:PRYOR
Mailing Address - State:OK
Mailing Address - Zip Code:74361-2339
Mailing Address - Country:US
Mailing Address - Phone:918-864-1514
Mailing Address - Fax:
Practice Address - Street 1:7307 S YALE AVE STE 101
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7134
Practice Address - Country:US
Practice Address - Phone:918-710-2062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK206691363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily