Provider Demographics
NPI:1336141753
Name:BURNS, KATHLEEN P (PA-C)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:P
Last Name:BURNS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:1 BRACE RD STE C1
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2600
Practice Address - Country:US
Practice Address - Phone:856-428-4100
Practice Address - Fax:856-427-5748
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2023-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA050743363AM0700X
NJ25MP00209800363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA092796TNYMedicare ID - Type Unspecified
Q03366Medicare UPIN