Provider Demographics
NPI:1164474060
Name:BURNS, KRISTINA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6219 GLEBE DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-9043
Mailing Address - Country:US
Mailing Address - Phone:317-781-0956
Mailing Address - Fax:317-782-0958
Practice Address - Street 1:6219 GLEBE DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-9043
Practice Address - Country:US
Practice Address - Phone:317-781-0956
Practice Address - Fax:317-782-0958
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31001230A225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics