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Individual

MARK DOUGLAS BURNS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN, CRNA

Contact information

Practice address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Mailing address
400 E THIRD STREET, SSB-5, DULUTH, MN 55805-1951
(218) 786-3146

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1230
MN
367500000X
Certified Registered Nurse Anesthetist
165395-30
WI
367500000X
Certified Registered Nurse Anesthetist
R132680-6
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
711178900
MN
Enumeration date
06/06/2006
Last updated
12/21/2020
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