Individual
MARY BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
216 HIGHWAY 51 N, BATESVILLE, MS 38606-2311
(662) 563-1858
(662) 563-0617
Mailing address
510 HIGHWAY 322, P O BOX 1216, CLARKSDALE, MS 38614-4717
(662) 624-4292
(662) 624-4354
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R856909
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121745
—
MS
Enumeration date
07/18/2005
Last updated
04/04/2011
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