Provider Demographics
NPI:1649513854
Name:BURNS, RUDOLPH BURNS JR (RN)
Entity type:Individual
Prefix:MR
First Name:RUDOLPH
Middle Name:BURNS
Last Name:BURNS
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 DOBBINS AVE
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29625-2842
Mailing Address - Country:US
Mailing Address - Phone:864-367-3748
Mailing Address - Fax:
Practice Address - Street 1:1921 DOBBINS AVE
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625-2842
Practice Address - Country:US
Practice Address - Phone:864-367-3748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-05
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC94888163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management