Provider Demographics
NPI:1336393222
Name:BURT, JOYCE ELLEN (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:ELLEN
Last Name:BURT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7530 204TH ST NE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-8912
Mailing Address - Country:US
Mailing Address - Phone:360-435-7337
Mailing Address - Fax:360-435-3510
Practice Address - Street 1:7530 204TH ST NE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-8912
Practice Address - Country:US
Practice Address - Phone:360-435-7337
Practice Address - Fax:360-435-3510
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60065612363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily