Healthcare Provider Details

I. General information

NPI: 1255360103
Provider Name (Legal Business Name): BARBARA J BURKLOW RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 RESEARCH DR
SACRAMENTO CA
95838
US

IV. Provider business mailing address

3909 DELMAR AVE
LOOMIS CA
95650
US

V. Phone/Fax

Practice location:
  • Phone: 916-648-0970
  • Fax:
Mailing address:
  • Phone: 916-652-7055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number308080
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: