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NPI Code Detail

MEDICARE: KATRINA BURKS NP

MEDICARE: KATRINA BURKS NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner084296-23NH
2363LF0000XFamily Nurse PractitionerCNP201517ME
3363LF0000XFamily Nurse Practitioner101.0109464VT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447633565
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATRINA BURKS NP
Provider Business Mailing Address
First Line : 784 HERCULES DR STE 110
Second Line : ATTN CREDENTIALING/RAYCHEL NELSON
City : COLCHESTER
State : VT
Zip : 05446-8049
Country : US
Telephone Number : 802-448-9787
Fax Number : 802-448-9787
Provider Business Practice Location Address
First Line : 173 SAINT PAUL ST
Second Line :
City : BURLINGTON
State : VT
Zip : 05401-4636
Country : US
Telephone Number : 866-476-1321
Fax Number : 802-863-4951
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2015
Last Update Date : 02/09/2023

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Directions to “ KATRINA BURKS NP” Practice Location

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