Individual
AVERY MARIE BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
777 HOSPITAL WAY, SUITE 204, POCATELLO, ID 83201-5175
(208) 239-2110
(208) 239-2119
Mailing address
P.O. BOX 4168, POCATELLO, ID 83205-4168
(208) 238-1035
(208) 239-3626
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
10997235-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
7871865
ID
Other
Enumeration date
04/02/2025
Last updated
11/28/2025
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