Provider Demographics
NPI:1245968791
Name:BURNETT, DEBORA (DVM)
Entity type:Individual
Prefix:DR
First Name:DEBORA
Middle Name:
Last Name:BURNETT
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 S BOULEVARD ST UNIT 5
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-3159
Mailing Address - Country:US
Mailing Address - Phone:970-784-6167
Mailing Address - Fax:
Practice Address - Street 1:420 S BOULEVARD ST UNIT 5
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-3159
Practice Address - Country:US
Practice Address - Phone:970-784-6167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7988261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care