Individual
REBECCA JO BURNAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C, PMHNP-BC
Contact information
Practice address
1485 M 139, BENTON HARBOR, MI 49022-5711
(269) 925-0585
(269) 927-1326
Mailing address
1485 M 139, BENTON HARBOR, MI 49022-5711
(269) 925-0585
(269) 927-1326
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704237274
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538482237
—
MI
Enumeration date
03/09/2010
Last updated
09/10/2021
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