Healthcare Provider Details

I. General information

NPI: 1689936700
Provider Name (Legal Business Name): MRS. NATASHA BURNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2012
Last Update Date: 06/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 PFEIFFER RD
CINCINNATI OH
45242
US

IV. Provider business mailing address

3330 S COUNTY ROAD 750 E
DILLSBORO IN
47018-9179
US

V. Phone/Fax

Practice location:
  • Phone: 513-985-0900
  • Fax:
Mailing address:
  • Phone: 702-234-7063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number019952
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: