Provider Demographics
NPI:1811066830
Name:MCBURROWS, LYDIA DH (MS RN CPNP)
Entity type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:DH
Last Name:MCBURROWS
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Gender:F
Credentials:MS RN CPNP
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Mailing Address - Street 1:7896 LAKE CREST DR
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-6750
Mailing Address - Country:US
Mailing Address - Phone:734-482-7292
Mailing Address - Fax:
Practice Address - Street 1:510 EMERICK ST
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-5702
Practice Address - Country:US
Practice Address - Phone:734-714-1409
Practice Address - Fax:734-714-1440
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2008-06-12
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Provider Licenses
StateLicense IDTaxonomies
MI4704207039363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4848338Medicaid