Provider Demographics
NPI:1508648056
Name:BURNETT, LYNETTE (LPN)
Entity Type:Individual
Prefix:
First Name:LYNETTE
Middle Name:
Last Name:BURNETT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 SAMUEL WAY
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14606-4000
Mailing Address - Country:US
Mailing Address - Phone:585-710-5555
Mailing Address - Fax:
Practice Address - Street 1:13 SAMUEL WAY
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14606-4000
Practice Address - Country:US
Practice Address - Phone:585-710-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY348602164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse