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General NPI Number Information
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NPI Number | 1962003863
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Entity Type | Individual
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Provider Name | KRISTEN DICKERSON BURNS APRN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 11/05/2020
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Last Update Date | 06/21/2021
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Provider Practice Location Address
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Address Line | 2530 BERT KOUNS INDUSTRIAL LOOP STE 138
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City | SHREVEPORT
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State | LA
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Zip | 71118-6114
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Country | US
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Telephone | 318-212-5911
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Fax |
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Provider Business Mailing Address
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Address Line | 1889 PINE ISLAND RD
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City | KARNACK
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State | TX
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Zip | 75661-1893
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Country | US
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Telephone | 903-720-8136
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 216092
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License Number State | LA
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