Provider Demographics
NPI:1881784338
Name:BURNS, NANCY LEE (DC)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LEE
Last Name:BURNS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 BENMONT AVE
Mailing Address - Street 2:SUITE 30
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201
Mailing Address - Country:US
Mailing Address - Phone:802-447-2110
Mailing Address - Fax:802-447-2110
Practice Address - Street 1:160 BENMONT AVE
Practice Address - Street 2:SUITE 30
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201
Practice Address - Country:US
Practice Address - Phone:802-447-2110
Practice Address - Fax:802-447-2110
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0060000876111N00000X
VT006-0000876111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN0001Medicaid
VT0VN0001Medicaid