1932201043 NPI number — ANN E. BURZYNSKI APRN

Table of content: ANN E. BURZYNSKI APRN (NPI 1932201043)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932201043 NPI number — ANN E. BURZYNSKI APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BURZYNSKI
Provider First Name:
ANN
Provider Middle Name:
E.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932201043
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/14/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 647
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONTPELIER
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05601-0647
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-223-6328
Provider Business Mailing Address Fax Number:
802-229-8004

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
286 HOSPITAL LOOP
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERLIN
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05602-9523
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-229-0591
Provider Business Practice Location Address Fax Number:
802-223-3667
Provider Enumeration Date:
09/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 364SP0809X , with the licence number:  101.0035775 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 163WP0808X , with the licence number: 101-0035775 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 989026B . This is a "MVP HEALTHCARE" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: P00448714 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 2208214 . This is a "CIGNA" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 1014128 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1932201043 . This is a "BLUE CROSS/BLUE SHIELD OF VERMONT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 405739 . This is a "MHN TRICARE" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".




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