Healthcare Provider Details

I. General information

NPI: 1710617261
Provider Name (Legal Business Name): ASHLEY ANN BURNS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 09/15/2024
Certification Date: 09/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3011 S LINDSAY RD STE 115
GILBERT AZ
85295-4334
US

IV. Provider business mailing address

3011 S LINDSAY RD STE 115
GILBERT AZ
85295-4334
US

V. Phone/Fax

Practice location:
  • Phone: 602-249-8578
  • Fax:
Mailing address:
  • Phone: 602-249-8578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number280594
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WG0100X
TaxonomyGastroenterology Registered Nurse
License NumberRN174369
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: