Provider Demographics
NPI:1356372056
Name:BURNS, DJUANA L (CRNP)
Entity type:Individual
Prefix:
First Name:DJUANA
Middle Name:L
Last Name:BURNS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 928
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:AL
Mailing Address - Zip Code:36081-0928
Mailing Address - Country:US
Mailing Address - Phone:334-566-7600
Mailing Address - Fax:334-566-1445
Practice Address - Street 1:1300 US HIGHWAY 231 S
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36081
Practice Address - Country:US
Practice Address - Phone:334-566-7600
Practice Address - Fax:334-566-1445
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-051914363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP74167Medicare UPIN