Healthcare Provider Details

I. General information

NPI: 1871361642
Provider Name (Legal Business Name): CHARLOTTE BURNS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2023
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OLATHE STE 5A
KANSAS CITY KS
66160-8505
US

IV. Provider business mailing address

2000 OLATHE STE 5A
KANSAS CITY KS
66160-8505
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-6022
  • Fax:
Mailing address:
  • Phone: 913-588-6022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number2024001179
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: