Healthcare Provider Details

I. General information

NPI: 1639008964
Provider Name (Legal Business Name): ARIADNE ALEXANDRA JOHNAS-BURK RN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 BROOKLINE AVE
BOSTON MA
02215-3904
US

IV. Provider business mailing address

11 WALNUT HILL RD
CHESTNUT HILL MA
02467-3124
US

V. Phone/Fax

Practice location:
  • Phone: 617-894-7104
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberRN169258
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: