Healthcare Provider Details

I. General information

NPI: 1720344294
Provider Name (Legal Business Name): KIMBERLY A. BURNS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2012
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 HOSPITAL DR
ST JOHNSBURY VT
05819-6001
US

IV. Provider business mailing address

7951 E MAPLEWOOD AVE STE 300
GREENWOOD VILLAGE CO
80111-4726
US

V. Phone/Fax

Practice location:
  • Phone: 802-473-4100
  • Fax:
Mailing address:
  • Phone: 303-930-7800
  • Fax: 303-930-7860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number990353
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number092129-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: