Provider Demographics
NPI:1053188813
Name:BURNS, RYAN CODY (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:CODY
Last Name:BURNS
Suffix:
Gender:M
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11331 JAMES WATT DR BLDG 100
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6401
Mailing Address - Country:US
Mailing Address - Phone:915-206-2150
Mailing Address - Fax:
Practice Address - Street 1:3100 N LEE TREVINO DR STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-2116
Practice Address - Country:US
Practice Address - Phone:915-533-7465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1131784363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily