Provider Demographics
NPI:1871765891
Name:BURNETT-MARTIN, ANGELA LATRICE (FNP)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:LATRICE
Last Name:BURNETT-MARTIN
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 1:7221 HWY 70 S
Mailing Address - Street 2:APT 135
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2835
Mailing Address - Country:US
Mailing Address - Phone:901-259-1920
Mailing Address - Fax:
Practice Address - Street 1:7221 HWY 70 S
Practice Address - Street 2:APT 135
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-2835
Practice Address - Country:US
Practice Address - Phone:615-752-5009
Practice Address - Fax:801-823-0674
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000013365363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily