Provider Demographics
NPI:1598557258
Name:BURNS, KYRA ANN
Entity type:Individual
Prefix:
First Name:KYRA
Middle Name:ANN
Last Name:BURNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2463 KEN BALE BLVD APT 32
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-6067
Mailing Address - Country:US
Mailing Address - Phone:270-401-3797
Mailing Address - Fax:
Practice Address - Street 1:730 FAIRVIEW AVE STE A8
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-2383
Practice Address - Country:US
Practice Address - Phone:615-469-7879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health