Healthcare Provider Details

I. General information

NPI: 1174519086
Provider Name (Legal Business Name): TARA E BURNS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6145 W CHANDLER BLVD # 2
CHANDLER AZ
85226-3434
US

IV. Provider business mailing address

6145 W CHANDLER BLVD # 2
CHANDLER AZ
85226-3434
US

V. Phone/Fax

Practice location:
  • Phone: 480-454-8744
  • Fax:
Mailing address:
  • Phone: 480-454-8744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6288
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: