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Individual

DEBORAH ANN BURNS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
611 S MARSHALL AVE, MC LEANSBORO, IL 62859-1213
(618) 643-2361
(618) 643-3917
Mailing address
611 S MARSHALL AVE, P.O. BOX 429, MC LEANSBORO, IL 62859-1213
(618) 643-2361
(618) 643-3917

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085002000
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
085-002000
IL LICENSE
IL
Enumeration date
10/15/2012
Last updated
02/12/2014
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