Provider Demographics
NPI:1205436839
Name:BURNS, IRIS (FNP-C)
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:IRIS
Other - Middle Name:
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:2487 S GILBERT RD
Mailing Address - Street 2:STE 106 PMB 406
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295
Mailing Address - Country:US
Mailing Address - Phone:915-248-1277
Mailing Address - Fax:915-845-9072
Practice Address - Street 1:1302 N. STANTON STREET
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4122
Practice Address - Country:US
Practice Address - Phone:915-248-1277
Practice Address - Fax:915-845-9072
Is Sole Proprietor?:No
Enumeration Date:2020-11-01
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM65194363LF0000X
TXAP143542363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily