Provider Demographics
NPI:1609239474
Name:BURROUS, AIMEE LEE (MNSC, APRN, AGACNP)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:LEE
Last Name:BURROUS
Suffix:
Gender:F
Credentials:MNSC, APRN, AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1464 N CORSICA DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-6167
Mailing Address - Country:US
Mailing Address - Phone:479-966-5342
Mailing Address - Fax:
Practice Address - Street 1:1464 N CORSICA DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-6167
Practice Address - Country:US
Practice Address - Phone:479-966-5342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARATP-000929363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine