Healthcare Provider Details

I. General information

NPI: 1396371944
Provider Name (Legal Business Name): CHRISTI BURKS AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. CHRISTI LYNNE BURKS

II. Dates (important events)

Enumeration Date: 03/16/2020
Last Update Date: 05/27/2020
Certification Date: 05/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10900 W 44TH AVE UNIT 200
WHEAT RIDGE CO
80033-2742
US

IV. Provider business mailing address

10900 W 44TH AVE UNIT 200
WHEAT RIDGE CO
80033-2742
US

V. Phone/Fax

Practice location:
  • Phone: 303-933-1330
  • Fax:
Mailing address:
  • Phone: 303-993-1330
  • Fax: 303-284-4082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0995450
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: