Provider Demographics
NPI:1467458646
Name:BURNS, GENEVIEVE KATHERINE (CRNP)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:KATHERINE
Last Name:BURNS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 JUSTIN DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-3428
Mailing Address - Country:US
Mailing Address - Phone:610-908-9776
Mailing Address - Fax:
Practice Address - Street 1:680 BLAIR MILL RD
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2223
Practice Address - Country:US
Practice Address - Phone:267-965-7962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP002316C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1137857OtherKEYSTONE MERCY HEALTH PLA
PA0159289101OtherAMERICHOICE OF PA
PA01592891Medicaid
PA1137857OtherKEYSTONE MERCY HEALTH PLA
PAP06739Medicare UPIN