Provider Demographics
NPI:1376208504
Name:BURNS, ANGELA LOPEZ (RN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:LOPEZ
Last Name:BURNS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:330 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-4375
Mailing Address - Country:US
Mailing Address - Phone:559-852-4853
Mailing Address - Fax:
Practice Address - Street 1:330 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4375
Practice Address - Country:US
Practice Address - Phone:559-852-4853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95231682163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse