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NPI Code Detail

MEDICARE: NEIKOLYN BURNS

MEDICARE: NEIKOLYN BURNS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner28138574AIN

General Provider Information

NPI Number : 1104374719
Entity Type Code : Individual
Provider Name (Legal Business Name) : NEIKOLYN BURNS
Provider Business Mailing Address
First Line : 7240 E 82ND ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-1404
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7240 E 82ND ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-1404
Country : US
Telephone Number : 317-849-8150
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2016
Last Update Date : 09/13/2016

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Directions to “ NEIKOLYN BURNS ” Practice Location

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