Provider Demographics
NPI:1720204498
Name:BURNETT, KATHARINE FRISCH (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:FRISCH
Last Name:BURNETT
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2363 FAIR AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2158
Mailing Address - Country:US
Mailing Address - Phone:914-912-3004
Mailing Address - Fax:413-637-1651
Practice Address - Street 1:175 TARRYTOWN RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1607
Practice Address - Country:US
Practice Address - Phone:914-761-6566
Practice Address - Fax:914-948-0010
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF360269-1363LX0001X
OHNP-03826363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology