Provider Demographics
NPI:1427534908
Name:BURNS, BECKY WARNER (TEACHER)
Entity Type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:WARNER
Last Name:BURNS
Suffix:
Gender:F
Credentials:TEACHER
Other - Prefix:MRS
Other - First Name:BECKY
Other - Middle Name:WARNER
Other - Last Name:CAPACILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1638 ALLISON DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-7752
Mailing Address - Country:US
Mailing Address - Phone:406-750-0335
Mailing Address - Fax:
Practice Address - Street 1:7300 N DYSART RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85307-2218
Practice Address - Country:US
Practice Address - Phone:623-876-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor