Provider Demographics
NPI:1801027362
Name:BURDETTE, DIANNE STEUDEL (RN, APN)
Entity type:Individual
Prefix:MRS
First Name:DIANNE
Middle Name:STEUDEL
Last Name:BURDETTE
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Gender:F
Credentials:RN, APN
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Mailing Address - Street 1:1100 ROUTE 72 W
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2468
Mailing Address - Country:US
Mailing Address - Phone:609-978-9639
Mailing Address - Fax:609-978-9685
Practice Address - Street 1:1100 ROUTE 72 W
Practice Address - Street 2:SUITE 304
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2468
Practice Address - Country:US
Practice Address - Phone:609-978-9639
Practice Address - Fax:609-978-9685
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2011-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00171200363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics