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Individual

MR. SCOTT G BURNSIDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
N.P.P.

Contact information

Practice address
3003 N CENTRAL AVE, SUITE 200, PHOENIX, AZ 85012-2902
(602) 302-7715
(602) 302-6973
Mailing address
1642 S PRIEST DR, BLDG. 6, SUITE 101, TEMPE, AZ 85281-6204
(480) 929-5100
(480) 731-1066

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
574003-1
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
401296
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP8253
AZ

Other

Enumeration date
07/02/2010
Last updated
11/06/2015
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