Healthcare Provider Details

I. General information

NPI: 1750872735
Provider Name (Legal Business Name): KAITLYN DREW BURNS MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2018
Last Update Date: 05/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 W 22ND ST
SIOUX FALLS SD
57105-1502
US

IV. Provider business mailing address

1321 W 22ND ST
SIOUX FALLS SD
57105-1502
US

V. Phone/Fax

Practice location:
  • Phone: 605-404-4283
  • Fax:
Mailing address:
  • Phone: 605-404-4283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: