Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | AP7568 | AZ |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP7568 | AZ |
NPI | 1023402435 |
---|---|
Provider Name | Joanna Burns |
First Address | Queen Creek, AZ 85142 |
Second Address | Phoenix, AZ 85034-2295 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2015 |
Last Update Date | 14/03/2021 |