Provider Demographics
NPI:1457410284
Name:BURNS, ERIN D (PA)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:D
Last Name:BURNS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MRS
Other - First Name:ERIN
Other - Middle Name:C
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:645 SIERRA ROSE DR., #103
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511
Mailing Address - Country:US
Mailing Address - Phone:775-322-3011
Mailing Address - Fax:775-323-1849
Practice Address - Street 1:645 SIERRA ROSE DR., #103
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511
Practice Address - Country:US
Practice Address - Phone:775-322-3011
Practice Address - Fax:775-323-1849
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10004985363AM0700X, 363AS0400X
NVPA1190363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8452252Medicaid
WA8862788Medicare PIN
WA8452252Medicaid
NVCQ075ZMedicare PIN