Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | RN2281236 | MA |
N | 363LP2300X | Nurse Practitioner - Primary Care | RN2281236 | MA |
NPI | 1063173631 |
---|---|
Provider Name | Anastasia Burns |
First Address | Boston, MA 02121-1869 |
Second Address | Brookline, MA 02446-6773 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2022 |
Last Update Date | 06/01/2022 |