=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457410284
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIN D BURNS P.A.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/07/2006
-----------------------------------------------------
Last Update Date | 12/03/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 645 SIERRA ROSE DR., #103
-----------------------------------------------------
City | RENO
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89511
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-322-3011
-----------------------------------------------------
Fax | 775-323-1849
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 645 SIERRA ROSE DR., #103
-----------------------------------------------------
City | RENO
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89511
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-322-3011
-----------------------------------------------------
Fax | 775-323-1849
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363AM0700X
-----------------------------------------------------
Taxonomy Name | Medical Physician Assistant
-----------------------------------------------------
License Number | PA10004985
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363AS0400X
-----------------------------------------------------
Taxonomy Name | Surgical Physician Assistant
-----------------------------------------------------
License Number | PA10004985
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363AM0700X
-----------------------------------------------------
Taxonomy Name | Medical Physician Assistant
-----------------------------------------------------
License Number | PA1190
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------