Individual provider Active NPI

Holly Elizabeth Burman, WHNP

  • Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1366590119
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN124541 Issued in GA
Practice address
3951 Mary Eliza Trce NW Ste 100
Marietta, GA 30064-1078
Phone
(770) 558-9773
Fax
(770) 739-6006
NPI assigned
Jan 8, 2007
Last updated
Feb 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN124541 GA Primary

Addresses

Primary practice location

3951 Mary Eliza Trce NW Ste 100
Marietta, GA 30064-1078

Mailing address

3951 Mary Eliza Trce NW Ste 100
Marietta, GA 30064-1078
Phone (770) 558-9773

Other practice location 1

880 Crestmark Dr
Suite 200
Lithia Springs, GA 30122-2646
Phone (770) 941-8662

Other identifiers 3

IdentifierTypeStateIssuer
090369480BMedicaidGA
090369480CMedicaidGA
090369480DMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amnestic, LLC Past Accepting new patients
Douglas Womens Center PC PastSince Nov 8, 2017 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1366590119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3951 MARY ELIZA TRCE NW STE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641078",
            "telephone_number": "770-558-9773",
            "fax_number": "770-739-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3951 MARY ELIZA TRCE NW STE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641078",
            "telephone_number": "770-558-9773",
            "fax_number": "770-739-6006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "880 Crestmark Dr",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Lithia Springs",
            "state": "GA",
            "postal_code": "301222646",
            "country_code": "US",
            "telephone_number": "770-941-8662",
            "fax_number": "770-739-6006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURMAN",
        "first_name": "HOLLY",
        "middle_name": "ELIZABETH",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2025-02-06",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN124541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090369480B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090369480C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090369480D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.