Provider Demographics
NPI:1700918687
Name:BURNHAM, LAURA ANNE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ANNE
Last Name:BURNHAM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8110 MAPLE LAWN BLVD STE 235
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2694
Mailing Address - Country:US
Mailing Address - Phone:301-340-8339
Mailing Address - Fax:301-340-9027
Practice Address - Street 1:7625 MAPLE LAWN BLVD
Practice Address - Street 2:STE 1, LOWER LOBBY
Practice Address - City:FULTON
Practice Address - State:MD
Practice Address - Zip Code:20759-2565
Practice Address - Country:US
Practice Address - Phone:410-531-7557
Practice Address - Fax:410-531-0818
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR144985363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD994LMedicare UPIN
MD216049YYKMedicare PIN