Individual
COURTNEY L BURRUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
1199 HADLEY RD STE 102, MOORESVILLE, IN 46158-1788
(317) 584-3454
(877) 245-5768
Mailing address
11595 N MERIDIAN ST STE 375, CARMEL, IN 46032-3950
(317) 575-7304
(317) 575-7333
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
28192069A
IN
363LW0102X
Women's Health Nurse Practitioner
Primary
71005655A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71005655A
INDIANA PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
08/12/2015
Last updated
12/29/2021
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