Provider Demographics
NPI:1295285211
Name:BURNS, KALEY (ND)
Entity type:Individual
Prefix:
First Name:KALEY
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 TOWN CENTER AVENUE
Mailing Address - Street 2:UNIT A-5
Mailing Address - City:BIG SKY
Mailing Address - State:MT
Mailing Address - Zip Code:59716-0913
Mailing Address - Country:US
Mailing Address - Phone:406-993-6949
Mailing Address - Fax:
Practice Address - Street 1:223 TOWN CENTER AVENUE
Practice Address - Street 2:UNIT A-5
Practice Address - City:BIG SKY
Practice Address - State:MT
Practice Address - Zip Code:59716
Practice Address - Country:US
Practice Address - Phone:406-993-6949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT175F00000X
175F00000X
MT1618175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath