Provider Demographics
NPI:1124479597
Name:BURNS, WILLIAM ALEXANDER (APRN)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ALEXANDER
Last Name:BURNS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 83
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:AR
Mailing Address - Zip Code:72422-0083
Mailing Address - Country:US
Mailing Address - Phone:870-857-3334
Mailing Address - Fax:870-857-9934
Practice Address - Street 1:201 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:WALNUT RIDGE
Practice Address - State:AR
Practice Address - Zip Code:72476-1410
Practice Address - Country:US
Practice Address - Phone:870-886-5507
Practice Address - Fax:870-886-5632
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004793363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily