Healthcare Provider Details

I. General information

NPI: 1710498753
Provider Name (Legal Business Name): JESSICA BURNS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2017
Last Update Date: 09/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10900 W 44TH AVE UNIT 200
WHEAT RIDGE CO
80033-2742
US

IV. Provider business mailing address

10900 W 44TH AVE UNIT 200
WHEAT RIDGE CO
80033-2742
US

V. Phone/Fax

Practice location:
  • Phone: 303-993-1330
  • Fax: 303-957-5757
Mailing address:
  • Phone: 720-923-1239
  • Fax: 303-284-4082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN.0993379-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: