Doctor Name: | MRS. ANITA RUCKER-BURNS |
NPI Number: | 1023323904 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 9323 E 83rd St Raytown, MO - 641382044 |
Business Phone Number: | 8163563412 |
Business Fax Number: | 8163563412 |
Mailing Address: | 9323 E 83rd St, RAYTOWN |
State: | MO |
Postal Code: | 641382044 |
Phone Number: | 8163563412 |
Fax Number: | 8163563412 |
NPI Enumeration Date: | 08/16/2010 |
NPI Last Update Date: | 08/16/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |