Individual
JEREMY K BURDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FPN
Contact information
Practice address
1501 S YALE ST, 252, FLAGSTAFF, AZ 86001-7304
(928) 774-1811
(928) 774-2006
Mailing address
1501 S YALE ST, 252, FLAGSTAFF, AZ 86001-7304
(928) 774-1811
(928) 774-2006
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN125139
AZ
Other
Enumeration date
07/22/2013
Last updated
07/22/2013
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