Provider Demographics
NPI:1992339279
Name:BURNS, ANGELA CATHERINE (MSN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:CATHERINE
Last Name:BURNS
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 FRANK SCOTT PKWY W STE 914
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62223-5000
Mailing Address - Country:US
Mailing Address - Phone:618-219-8634
Mailing Address - Fax:
Practice Address - Street 1:2900 FRANK SCOTT PARKWAY WEST
Practice Address - Street 2:SUITE 914
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62223
Practice Address - Country:US
Practice Address - Phone:618-219-8634
Practice Address - Fax:618-545-9040
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209020971363LF0000X, 363L00000X
MO2020014286363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily