Individual
KATHRYN BURSTALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1223 GATEWAY DR STE 2F, MELBOURNE, FL 32901-2607
(321) 312-3487
(321) 956-2542
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 312-3487
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APRN11043441
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11043441
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130661100
—
FL
01
—
PENDING
HFMG
FL
01
—
W9524
HFMG
FL
Enumeration date
02/09/2026
Last updated
04/01/2026
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