MEDICARE: JAMIE NICOLE BURNS CRNA

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
1	367500000X	Certified Registered Nurse Anesthetist	6312	NC
2	367500000X	Certified Registered Nurse Anesthetist	128760	TN

General Provider Information

NPI Number	:	1285271841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE NICOLE BURNS CRNA

Provider Business Mailing Address
First Line	:	304 PARK GLEN DR
Second Line	:
City	:	MOUNT JULIET
State	:	TN
Zip	:	37122-5607
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 BLYTHE BLVD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28203-5871
Country	:	US
Telephone Number	:	704-355-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2019
Last Update Date	:	12/11/2024

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