Provider Demographics
NPI:1700841301
Name:BURNS, JULIE M (APRN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:BURNS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:M
Other - Last Name:BANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:109 BROWNS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TOLLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06084-2019
Mailing Address - Country:US
Mailing Address - Phone:860-454-7370
Mailing Address - Fax:
Practice Address - Street 1:109 BROWNS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:TOLLAND
Practice Address - State:CT
Practice Address - Zip Code:06084-2019
Practice Address - Country:US
Practice Address - Phone:860-454-7370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001298363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT500002302Medicare UPIN
P03521Medicare UPIN