Provider Demographics
NPI:1700902012
Name:BURNS, CHRISTINE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:KAZONICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5437 KIETZKE LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-1088
Mailing Address - Country:US
Mailing Address - Phone:775-322-4550
Mailing Address - Fax:775-322-4956
Practice Address - Street 1:5437 KIETZKE LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-1088
Practice Address - Country:US
Practice Address - Phone:775-322-4550
Practice Address - Fax:775-322-4956
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1128363AM0700X, 363AM0700X
FLPA9109005363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV11807694OtherCAQH
P42315Medicare UPIN
NVP42315Medicare UPIN
11807694OtherCAQH
NVCM8132Medicare PIN