Provider Demographics
NPI:1205471315
Name:BURNS, ALYSSA JEAN (RN)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:JEAN
Last Name:BURNS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-3361
Mailing Address - Country:US
Mailing Address - Phone:978-840-9312
Mailing Address - Fax:
Practice Address - Street 1:40 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-3361
Practice Address - Country:US
Practice Address - Phone:978-840-9312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2303362163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health