Healthcare Provider Details

I. General information

NPI: 1154241818
Provider Name (Legal Business Name): CHRISTOPHER BURNS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3570 E FLAMINGO RD
LAS VEGAS NV
89121-5000
US

IV. Provider business mailing address

805 N 4TH AVE UNIT 509
PHOENIX AZ
85003-1305
US

V. Phone/Fax

Practice location:
  • Phone: 702-436-7911
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number105615
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: