Healthcare Provider Details

I. General information

NPI: 1356888325
Provider Name (Legal Business Name): DANIELLE BURNS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2017
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 HOSPITAL DR
VICTORIA TX
77901-5749
US

IV. Provider business mailing address

PO BOX 4897
HOUSTON TX
77210-4897
US

V. Phone/Fax

Practice location:
  • Phone: 361-573-9181
  • Fax:
Mailing address:
  • Phone: 888-991-1101
  • Fax: 903-787-5854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number814621
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP133169
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: