Provider Demographics
NPI:1437360963
Name:BURNS, EDNA (RN)
Entity type:Individual
Prefix:
First Name:EDNA
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2583 IRETON TREES RD
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:OH
Mailing Address - Zip Code:45153-9750
Mailing Address - Country:US
Mailing Address - Phone:513-876-3283
Mailing Address - Fax:
Practice Address - Street 1:2583 IRETON TREES RD
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:OH
Practice Address - Zip Code:45153-9750
Practice Address - Country:US
Practice Address - Phone:513-876-3283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN213909163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2689345Medicaid