Provider Demographics
NPI:1790094431
Name:BURNS, JESSICA ILYSE (RN, MSN, WHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ILYSE
Last Name:BURNS
Suffix:
Gender:F
Credentials:RN, MSN, WHNP-BC
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Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:6981 N PARK DR STE 300A
Practice Address - Street 2:
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-4205
Practice Address - Country:US
Practice Address - Phone:856-854-4524
Practice Address - Fax:856-365-7972
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NR14211700163WW0101X
NJ26NJ00305100363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory