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Contact Information

LANCE R BURRELL, APRN
EXIT 102 11/2 MI. SOUTH I-40
ACOMA-CANONCITO-LAGUNA INDIAN
SAN FIDEL, NM87049-0130
 Phone: 505-552-5300
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for LANCE R BURRELL · (Male)

NPI # 1730146754
Status Active
Credentials APRN (Advanced Practice Registered Nurse)
Entity Individual
Enumeration date 04/26/2006
Last updated 09/02/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • AZ License # AP4694
  • UT License # 5653727-4405
  • NM Medicaid H3451
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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