Provider Demographics
NPI:1316087273
Name:BURNS, DEBORAH JEANNE (NNP)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:JEANNE
Last Name:BURNS
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 E REBECCA CIR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-5864
Mailing Address - Country:US
Mailing Address - Phone:801-278-2907
Mailing Address - Fax:
Practice Address - Street 1:5495 S 500 E
Practice Address - Street 2:SUITE 100
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-6923
Practice Address - Country:US
Practice Address - Phone:801-476-4280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT215653-4405363LN0005X
UT21563-4405363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care