Individual
THERESE M. BURNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
W487 STATE ROAD 67, SAINT CLOUD, WI 53079-1706
(920) 477-6900
Mailing address
W487 STATE ROAD 67, SAINT CLOUD, WI 53079-1706
(920) 477-6900
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
23758-031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35056200
—
WI
Enumeration date
05/20/2008
Last updated
05/20/2008
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