Provider Demographics
NPI:1437552387
Name:BURNS, MARLAINA (CRNP)
Entity Type:Individual
Prefix:
First Name:MARLAINA
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MARLENE
Other - Middle Name:
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:930 QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1120
Mailing Address - Country:US
Mailing Address - Phone:314-322-8384
Mailing Address - Fax:
Practice Address - Street 1:930 QUINCY AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1120
Practice Address - Country:US
Practice Address - Phone:314-322-8384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-07
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012782171W00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No171W00000XOther Service ProvidersContractor