Provider Demographics
NPI:1336925544
Name:BURNETT, KAYLA ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:ANN
Last Name:BURNETT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 ERIC DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-1720
Mailing Address - Country:US
Mailing Address - Phone:505-289-9976
Mailing Address - Fax:
Practice Address - Street 1:2101 NORTHERN BLVD NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-4727
Practice Address - Country:US
Practice Address - Phone:505-217-3980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00010009183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist