Healthcare Provider Details

I. General information

NPI: 1184190688
Provider Name (Legal Business Name): AMY MARIE BURKE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2018
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 E. MOUTAIN VIEW RD #220
SCOTTSDALE AZ
85258
US

IV. Provider business mailing address

948 CLIVE ST
PITTSBURGH PA
15202-2841
US

V. Phone/Fax

Practice location:
  • Phone: 877-564-9627
  • Fax:
Mailing address:
  • Phone: 570-905-3280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberSP019467
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberSP019467
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: