Healthcare Provider Details

I. General information

NPI: 1679262547
Provider Name (Legal Business Name): MEGAN ELISE BURK RN, PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN ELISE LEVY RN, PHN

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 SUTTER PL STE 203
DAVIS CA
95616-6217
US

IV. Provider business mailing address

PO BOX 255228
SACRAMENTO CA
95865-5228
US

V. Phone/Fax

Practice location:
  • Phone: 530-750-5880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number819391
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberNM236440
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: