Provider Demographics
NPI:1740789577
Name:BURMOOD, ROSLYN RAE (CPM)
Entity Type:Individual
Prefix:MRS
First Name:ROSLYN
Middle Name:RAE
Last Name:BURMOOD
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3323 NW ELMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-1105
Mailing Address - Country:US
Mailing Address - Phone:541-760-3656
Mailing Address - Fax:
Practice Address - Street 1:3323 NW ELMWOOD DR
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-1105
Practice Address - Country:US
Practice Address - Phone:541-760-3656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDEM-LD-10187349176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife