Provider Demographics
NPI:1891277455
Name:BURNS, ANDREA KAY (DNP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:KAY
Last Name:BURNS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:K
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP
Mailing Address - Street 1:1100 BERGSLIEN ST
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:WI
Mailing Address - Zip Code:54002-2600
Mailing Address - Country:US
Mailing Address - Phone:715-684-1111
Mailing Address - Fax:715-684-1119
Practice Address - Street 1:1100 BERGSLIEN ST
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:WI
Practice Address - Zip Code:54002-2600
Practice Address - Country:US
Practice Address - Phone:715-684-1111
Practice Address - Fax:715-684-1119
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8613363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology