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NPI Code Detail

MEDICARE: JACQUELINE BURNS

MEDICARE:   JACQUELINE  BURNS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1982144788
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE BURNS
Provider Business Mailing Address
First Line : 3801 E CHARLESTON BLVD
Second Line : 3103
City : LAS VEGAS
State : NV
Zip : 89104-2319
Country : US
Telephone Number : 702-472-6771
Fax Number :
Provider Business Practice Location Address
First Line : 3801 E CHARLESTON BLVD
Second Line : 3103
City : LAS VEGAS
State : NV
Zip : 89104-2319
Country : US
Telephone Number : 702-472-6771
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2017
Last Update Date : 02/28/2017

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Directions to “ JACQUELINE BURNS ” Practice Location

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