Provider Demographics
NPI:1164136735
Name:BURNS, ALEXANDRA KAITLYN (MS, LAT,ATC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:KAITLYN
Last Name:BURNS
Suffix:
Gender:F
Credentials:MS, LAT,ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 WOODS WAY
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-8972
Mailing Address - Country:US
Mailing Address - Phone:570-534-3041
Mailing Address - Fax:
Practice Address - Street 1:77 S COMMERCE WAY
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-8891
Practice Address - Country:US
Practice Address - Phone:484-526-3177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer