Healthcare Provider Details

I. General information

NPI: 1326252289
Provider Name (Legal Business Name): PAMALA SUE BURNS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PAMALA SUE BURNS RN

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 12/21/2020
Certification Date: 12/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8126 RUNNING FOX RD APT 1B
COLUMBUS OH
43235-4484
US

IV. Provider business mailing address

8126 RUNNING FOX RD APT 1B
COLUMBUS OH
43235-4484
US

V. Phone/Fax

Practice location:
  • Phone: 567-204-8794
  • Fax:
Mailing address:
  • Phone: 567-204-8794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number327334
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: