Healthcare Provider Details

I. General information

NPI: 1285009928
Provider Name (Legal Business Name): KIMBERLY PAIGE BURNS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2015
Last Update Date: 12/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MEDICAL PARK DR E
BIRMINGHAM AL
35235-3401
US

IV. Provider business mailing address

2016 STONEGATE TRL SUITE 112
VESTAVIA HLS AL
35242-2260
US

V. Phone/Fax

Practice location:
  • Phone: 205-545-9530
  • Fax: 205-545-9529
Mailing address:
  • Phone: 205-545-9530
  • Fax: 205-545-9529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-102557
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: