Provider Demographics
NPI:1861284291
Name:BURNS SR, JOHN W
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:BURNS SR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 SYCAMORE AVE # NE68901
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-3301
Mailing Address - Country:US
Mailing Address - Phone:402-984-1850
Mailing Address - Fax:402-984-1850
Practice Address - Street 1:1916 W 9TH ST
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-3612
Practice Address - Country:US
Practice Address - Phone:402-469-4886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker