Individual
KEVERIN BURNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1164 BROOKTROUT DR, VICTOR, ID 83455-4994
(208) 787-4483
Mailing address
1164 BROOKTROUT DR, VICTOR, ID 83455-4994
(208) 787-4483
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/31/2009
Last updated
08/31/2009
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