Provider Demographics
NPI:1295003895
Name:BURNS, JULIE A (RN,BSN,CDE)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:A
Last Name:BURNS
Suffix:
Gender:F
Credentials:RN,BSN,CDE
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4065 MACCORKLE AVE SW
Mailing Address - Street 2:THOMAS HOSPITAL DIABETES CENTER
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309
Mailing Address - Country:US
Mailing Address - Phone:304-766-5616
Mailing Address - Fax:304-766-3796
Practice Address - Street 1:4605 MACCORKLE AVE SW
Practice Address - Street 2:THOMAS HOSPITAL DIABETES CENTER
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1311
Practice Address - Country:US
Practice Address - Phone:304-766-5616
Practice Address - Fax:304-766-3796
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRN 59362163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator