MEDICARE: ABIGAIL S BURKE FNP-BC

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
1	363LF0000X	Family Nurse Practitioner	RN1007488	DC
2	363LF0000X	Family Nurse Practitioner	0024167750	VA

General Provider Information

NPI Number	:	1609030022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL S BURKE FNP-BC

Provider Business Mailing Address
First Line	:	4701 SANGAMORE RD STE S207
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20816-2529
Country	:	US
Telephone Number	:	202-684-7167
Fax Number	:

Provider Business Practice Location Address
First Line	:	4701 SANGAMORE RD STE S207
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20816-2529
Country	:	US
Telephone Number	:	202-684-7167
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2008
Last Update Date	:	11/01/2012

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