MEDICARE: MS. JULIE HATCH BURK FNP

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	71002630A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	234810C	OTHER		MEDICARE NUM
3	235780C	OTHER		MEDICARE NUM

Other Identifiers

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

General Provider Information

NPI Number	:	1841455318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULIE HATCH BURK FNP

Provider Business Mailing Address
First Line	:	2211 E 10TH ST
Second Line	:	BRICKIE COMMUNITY HEALTH CLINIC
City	:	HOBART
State	:	IN
Zip	:	46342-5313
Country	:	US
Telephone Number	:	219-945-9383
Fax Number	:	219-945-9384

Provider Business Practice Location Address
First Line	:	2211 E 10TH ST
Second Line	:	BRICKIE COMMUNITY HEALTH CLINIC
City	:	HOBART
State	:	IN
Zip	:	46342-5313
Country	:	US
Telephone Number	:	219-945-9383
Fax Number	:	219-945-9384

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

Provider Enumeration Date	:	07/24/2008
Last Update Date	:	01/20/2014

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