Healthcare Provider Details

I. General information

NPI: 1437783545
Provider Name (Legal Business Name): BRAD MICHAEL BURNS DNP, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2020
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

914 E BROADWAY
LOUISVILLE KY
40204-1037
US

IV. Provider business mailing address

8619 BROECKER BLVD
LOUISVILLE KY
40241-6103
US

V. Phone/Fax

Practice location:
  • Phone: 502-589-8600
  • Fax: 502-589-8745
Mailing address:
  • Phone: 502-589-8600
  • Fax: 502-589-8745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN572643
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4053365
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP021762
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: