Provider Demographics
NPI:1992367536
Name:BURNS, JOAN MARIE (DNP, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:MARIE
Last Name:BURNS
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 RUTLAND CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206-3126
Mailing Address - Country:US
Mailing Address - Phone:575-405-8559
Mailing Address - Fax:
Practice Address - Street 1:409 EVELYN DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-5212
Practice Address - Country:US
Practice Address - Phone:803-216-0850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22997363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC22997OtherAPRN LICENSE
MB5350474OtherDEA NUMBER