Provider Demographics
NPI:1720210362
Name:BURGAN, BABETTE RENE (NP-C)
Entity Type:Individual
Prefix:MISS
First Name:BABETTE
Middle Name:RENE
Last Name:BURGAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1191
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-7891
Mailing Address - Country:US
Mailing Address - Phone:585-766-8303
Mailing Address - Fax:
Practice Address - Street 1:85 SPRINGWOOD DR
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2811
Practice Address - Country:US
Practice Address - Phone:585-766-8303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-16
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF309419-01363LA2200X
NY606785-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse