Provider Demographics
NPI:1114666534
Name:BURNS, ALEXANDRA J (RDN)
Entity Type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:J
Last Name:BURNS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32532 HIGHWAY 6 APT 4204
Mailing Address - Street 2:
Mailing Address - City:EDWARDS
Mailing Address - State:CO
Mailing Address - Zip Code:81632-5140
Mailing Address - Country:US
Mailing Address - Phone:504-275-5214
Mailing Address - Fax:
Practice Address - Street 1:2205 CORDILLERA WAY
Practice Address - Street 2:
Practice Address - City:EDWARDS
Practice Address - State:CO
Practice Address - Zip Code:81632-6290
Practice Address - Country:US
Practice Address - Phone:504-275-5214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered