Individual
JUANITA RENEE BURTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
200 MEDICAL DR, HAMPTON, VA 23666-1763
(757) 374-0869
Mailing address
3419 VIRGINIA BEACH BLVD # 5436, VIRGINIA BEACH, VA 23452-4419
(757) 374-0869
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024283000
VA
Other
Enumeration date
11/12/2021
Last updated
01/04/2022
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