MEDICARE: HEATHER BURKEEN

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1831831841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER BURKEEN

Provider Business Mailing Address
First Line	:	30930 HIGHWAY 18
Second Line	:
City	:	MEDON
State	:	TN
Zip	:	38356-8750
Country	:	US
Telephone Number	:	731-265-1997
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 OLD HUMBOLDT RD # D
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-3506
Country	:	US
Telephone Number	:	731-256-6456
Fax Number	:

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

Provider Enumeration Date	:	04/11/2022
Last Update Date	:	05/23/2025

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Directions to “ HEATHER BURKEEN ” Practice Location

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