Provider Demographics
NPI:1437124377
Name:BURNS, ERIN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-3709
Mailing Address - Country:US
Mailing Address - Phone:570-714-4090
Mailing Address - Fax:570-714-4937
Practice Address - Street 1:2 POPLAR ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-3709
Practice Address - Country:US
Practice Address - Phone:570-714-4090
Practice Address - Fax:570-714-4937
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA000975363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1031489820001Medicaid
PA172406L3FMedicare PIN