| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MARISA LYNN BURDOLSKI | 1033822333 | 2023-08-17 |
Marisa Lynn Burdolski is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1033822333. Registration indicates Marisa Lynn Burdolski is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| Entity Type | Individual |
| Provider Name | Marisa Lynn Burdolski NP |
| Practice Office Address | 15137 ROSEWOOD DR LEAWOOD, KS US |
| Practice Office Telephone | 9132910194 |
| Mailing Address | 5809 AMINDA ST SHAWNEE, KS 662267933 US |
| Business Telephone | 9135157859 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 2040 Hutton Rd | Kansas City, KS 661094526 | 9132993700 |
| Code | Practice | License No State |
|---|---|---|
| 363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 53-81871-031
KS |
| 1811955024 | MEDICAID | KS |