Provider Demographics
NPI:1538246582
Name:BURBANK, CATHERINE DORA (FNP)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:DORA
Last Name:BURBANK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 UNIVERSITY DR.
Mailing Address - Street 2:SUITE 201 SLEEP MEDICINE SERVICES OF WESTERN MA.
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002
Mailing Address - Country:US
Mailing Address - Phone:413-253-2767
Mailing Address - Fax:413-253-9767
Practice Address - Street 1:170 UNIVERSITY DR.
Practice Address - Street 2:SUITE 201 SLEEP MEDICINE SERVICES OF WESTERN MA.
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002
Practice Address - Country:US
Practice Address - Phone:413-253-2767
Practice Address - Fax:413-253-9767
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA129286363L00000X, 163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner