Healthcare Provider Details

I. General information

NPI: 1477643252
Provider Name (Legal Business Name): CAROL A BURNS CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 WITHERSPOON ST
PRINCETON NJ
08540-3211
US

IV. Provider business mailing address

PO BOX 3563
PRINCETON NJ
08543-3563
US

V. Phone/Fax

Practice location:
  • Phone: 972-932-1302
  • Fax: 972-932-1312
Mailing address:
  • Phone: 972-932-1312
  • Fax: 973-932-1312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNO78511
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: