Healthcare Provider Details

I. General information

NPI: 1376357962
Provider Name (Legal Business Name): MICHAEL JAMES BURNS APRN, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 CORDAY ST
PENSACOLA FL
32503-2214
US

IV. Provider business mailing address

PO BOX 95590
SOUTH JORDAN UT
84095-0590
US

V. Phone/Fax

Practice location:
  • Phone: 850-908-2315
  • Fax: 850-908-2307
Mailing address:
  • Phone: 801-784-0954
  • Fax: 801-352-7976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11037863
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: