Provider Demographics
NPI:1588491237
Name:BURNS, CHRISTY LYNN (FNP)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:LYNN
Last Name:BURNS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 COUNTY ROAD 5008
Mailing Address - Street 2:
Mailing Address - City:BOONEVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38829-9070
Mailing Address - Country:US
Mailing Address - Phone:662-416-5894
Mailing Address - Fax:
Practice Address - Street 1:2209 N 2ND ST
Practice Address - Street 2:
Practice Address - City:BOONEVILLE
Practice Address - State:MS
Practice Address - Zip Code:38829-7734
Practice Address - Country:US
Practice Address - Phone:662-728-0162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906938363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily