Healthcare Provider Details

I. General information

NPI: 1871697938
Provider Name (Legal Business Name): KEVIN D. BURNS PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VETERANS DR VA MEDICAL CENTER (119)
MINNEAPOLIS MN
55417-2309
US

IV. Provider business mailing address

1100 DOVE CT
CHANHASSEN MN
55317-8536
US

V. Phone/Fax

Practice location:
  • Phone: 612-725-2000
  • Fax: 612-727-5654
Mailing address:
  • Phone: 952-937-9878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number114214-5
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: