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NPI Code Detail

MEDICARE: MS. KATHLEEN ANN BURKE WHNP

MEDICARE: MS. KATHLEEN ANN BURKE WHNP
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
1363LW0102XWomen's Health Nurse Practitioner5124377-4405UT

General Provider Information

NPI Number : 1477542363
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHLEEN ANN BURKE WHNP
Provider Business Mailing Address
First Line : 1589 PRINCETON AVE
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84105-1735
Country : US
Telephone Number : 801-583-0744
Fax Number :
Provider Business Practice Location Address
First Line : 654 S 900 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-3478
Country : US
Telephone Number : 801-521-2744
Fax Number : 801-532-5748
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2005
Last Update Date : 07/08/2007

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