MEDICARE: MRS. MARLEEN LOUISE BURNS ARNP

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	363LF0000X	Family Nurse Practitioner	209.025566	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	0576302	OTHER	KY	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770654493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARLEEN LOUISE BURNS ARNP

Provider Business Mailing Address
First Line	:	40 SHANNON CT
Second Line	:
City	:	HIGHLAND
State	:	IL
Zip	:	62249-1097
Country	:	US
Telephone Number	:	859-620-8998
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 SALEM PL
Second Line	:
City	:	FAIRVIEW HEIGHTS
State	:	IL
Zip	:	62208-1341
Country	:	US
Telephone Number	:	618-632-0304
Fax Number	:

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	07/31/2023

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