Individual
MARK BURNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3500 TWIN PEAKS BLVD, FARMINGTON, NM 87401-8515
(505) 599-8613
(877) 867-1749
Mailing address
3500 TWIN PEAKS BLVD, FARMINGTON, NM 87401-8515
(505) 599-8613
(877) 867-1749
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-77826
NM
163WS0200X
School Registered Nurse
Primary
372972
NM
Other
Enumeration date
08/19/2016
Last updated
08/19/2016
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