Individual
MRS. AMANDA VERKRUISSEN BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1717 OAK PARK BLVD FL 1, LAKE CHARLES, LA 70601-8977
(337) 494-6800
(337) 494-6761
Mailing address
PO BOX 122205 DEPT 2205, DALLAS, TX 75312-2205
(337) 494-2772
(337) 494-2928
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP0071
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2102605
—
LA
01
—
AP0071
STATE MEDICAL LICENSE
LA
Enumeration date
03/10/2010
Last updated
04/27/2022
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