Provider Demographics
NPI:1811962897
Name:BURNETT, DEBBIE LYNN (DME)
Entity type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:LYNN
Last Name:BURNETT
Suffix:
Gender:F
Credentials:DME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHANUTE
Mailing Address - State:KS
Mailing Address - Zip Code:66720-1412
Mailing Address - Country:US
Mailing Address - Phone:620-431-7743
Mailing Address - Fax:620-431-7745
Practice Address - Street 1:1110 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CHANUTE
Practice Address - State:KS
Practice Address - Zip Code:66720-1412
Practice Address - Country:US
Practice Address - Phone:620-431-7743
Practice Address - Fax:620-431-7745
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS5435670001Medicare NSC