Healthcare Provider Details

I. General information

NPI: 1528471844
Provider Name (Legal Business Name): ANNINA BURNS NU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2014
Last Update Date: 06/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2013 NEW HAMPSHIRE AVE NW SUITE 101
WASHINGTON DC
20009-3452
US

IV. Provider business mailing address

2013 NEW HAMPSHIRE AVE NW SUITE 101
WASHINGTON DC
20009-3452
US

V. Phone/Fax

Practice location:
  • Phone: 202-417-6679
  • Fax: 202-478-1737
Mailing address:
  • Phone: 202-417-6679
  • Fax: 202-478-1737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberNU100000154
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: