Burrell, Lance R
Burrell, Lance R is an sole proprietor health care provider with primary practice located at Exit 102 11/2 Mi. South I-40 Acoma-Canoncito-Laguna Indian, San Fidel NM 87049-0130. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Burrell, Lance R can be contacted via phone (505) 552-5300.Contact Information
Primary practice address
Exit 102 11/2 Mi. South I-40 Acoma-Canoncito-Laguna Indian
San Fidel NM 87049-0130
Phone: (505) 552-5300
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 5653727-4405 | Utah |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP4694 | Arizona |
Profile Details
| NPI number | 1730146754 |
|---|---|
| LBN Legal business name | Burrell, Lance R |
| Credentials | Advanced Practice Registered Nurse (APRN) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 26th, 2006 |
| Last updated | Sep 2nd, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730146754 | NPPES |
| New Mexico | MEDICAID | H3451 |
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