Doctor Name: | KRISTINE BURNS |
NPI Number: | 1104129113 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | 5007323 |
Business Practice Address: | 12000 Retail Dr Wake Forest, NC - 275877353 |
Business Phone Number: | 9197611001 |
Business Fax Number: | |
Mailing Address: | 12000 Retail Dr, WAKE FOREST |
State: | NC |
Postal Code: | 275877353 |
Phone Number: | 9197611001 |
Fax Number: | |
NPI Enumeration Date: | 12/13/2010 |
NPI Last Update Date: | 12/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 5007323 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |