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General NPI Number Information
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NPI Number | 1780128207
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Entity Type | Individual
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Provider Name | BRANDI NICOLE BURNS PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/19/2016
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Last Update Date | 02/06/2018
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Provider Practice Location Address
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Address Line | 1517 POND ROAD
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City | ALLENTOWN
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State | PA
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Zip | 18104
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Country | US
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Telephone | 610-395-4444
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Fax | 610-366-7886
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Provider Business Mailing Address
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Address Line | 1517 POND ROAD
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City | ALLENTOWN
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State | PA
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Zip | 18104
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Country | US
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Telephone | 610-395-4444
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Fax | 610-366-7886
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA058804
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MA058804
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License Number State | PA
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