Provider Demographics
NPI:1669527172
Name:BURNS, FELICA HOWARD (PMH-NP, BC)
Entity type:Individual
Prefix:MRS
First Name:FELICA
Middle Name:HOWARD
Last Name:BURNS
Suffix:
Gender:F
Credentials:PMH-NP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 BARRET AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-1667
Mailing Address - Country:US
Mailing Address - Phone:502-289-5412
Mailing Address - Fax:502-585-9466
Practice Address - Street 1:1028 BARRET AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40204-1667
Practice Address - Country:US
Practice Address - Phone:502-289-5412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1083323163WP0809X
KY3003579363LP0808X
KY3579S364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Not Answered364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY4763090000OtherMAGELLAN
KY9037Medicaid
KY000000113141OtherANTHEM
KY000000113141OtherANTHEM
KY0320713Medicare ID - Type Unspecified