Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 53-75135-081 | KS |
NPI | 1285940890 |
---|---|
Provider Name | Jessica Burns |
First Address | Kansas City, KS 66160 |
Second Address | Kansas City, KS 66160 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2010 |
Last Update Date | 20/08/2010 |