Individual
BRANDI NICOLE BURBANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1300 N 17TH AVE, GREELEY, CO 80631-9584
(970) 347-2120
Mailing address
1300 N 17TH AVE, GREELEY, CO 80631-9584
(970) 347-2120
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.0331704
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
912145784
UNITED HEATHCARE
CO
Enumeration date
12/19/2017
Last updated
12/19/2017
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