Individual
JAELAN NICOLE BURNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
585 W PECAN ST APT 1103, STEPHENVILLE, TX 76401-5512
(281) 619-6755
Mailing address
585 W PECAN ST APT 1103, STEPHENVILLE, TX 76401-5512
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390200000X
—
TX
Enumeration date
04/15/2019
Last updated
04/15/2019
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