Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 25180 | SC |
NPI | 1093388142 |
---|---|
Provider Name | Mrs. Patricia Williamson Burns |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-0100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2021 |
Last Update Date | 16/07/2021 |