Individual
LARA M BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
920 N MAIN ST, O FALLON, MO 63366-1746
(314) 687-2731
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-1352
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2009032404
MO
363LF0000X
Family Nurse Practitioner
2009032404
MO
Other
Enumeration date
01/28/2010
Last updated
10/20/2020
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