Healthcare Provider Details

I. General information

NPI: 1679429633
Provider Name (Legal Business Name): MARIE A BURNS CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 ATTICA DR
SAINT LOUIS MO
63137-1526
US

IV. Provider business mailing address

1120 TECHNOLOGY DR STE 113B
O FALLON MO
63368-2201
US

V. Phone/Fax

Practice location:
  • Phone: 314-643-7575
  • Fax:
Mailing address:
  • Phone: 314-643-7575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: