Doctor Name: | DR. AMANDA MARIE BURNS |
NPI Number: | 1548557630 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 2011019840 |
Business Practice Address: | 2200 John R Wooden Dr Martinsville, IN - 461511863 |
Business Phone Number: | 3179880112 |
Business Fax Number: | 3179885512 |
Mailing Address: | 2200 John R Wooden Dr, MARTINSVILLE |
State: | IN |
Postal Code: | 461511863 |
Phone Number: | 3179880112 |
Fax Number: | 3179885512 |
NPI Enumeration Date: | 07/08/2011 |
NPI Last Update Date: | 10/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 2011019840 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |