Provider Demographics
NPI:1124901970
Name:BURNETTE, KRISTIE (MSN, RN)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:
Last Name:BURNETTE
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2913 ROYAL CREST DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-3792
Mailing Address - Country:US
Mailing Address - Phone:804-283-3277
Mailing Address - Fax:
Practice Address - Street 1:4200 INNSLAKE DR STE 203
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-6772
Practice Address - Country:US
Practice Address - Phone:804-965-1226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001194488163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator