Provider Demographics
NPI:1912232893
Name:BURT, NANCYLEE (ARNP)
Entity Type:Individual
Prefix:
First Name:NANCYLEE
Middle Name:
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 1:1001 E 1200 ROAD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-9447
Mailing Address - Country:US
Mailing Address - Phone:785-865-5300
Mailing Address - Fax:785-865-1399
Practice Address - Street 1:2323 RIDGE CT
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66046-3956
Practice Address - Country:US
Practice Address - Phone:785-865-5300
Practice Address - Fax:785-865-1399
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1346743031367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife