Healthcare Provider Details

I. General information

NPI: 1427131143
Provider Name (Legal Business Name): CAYLA J BURKE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 10/16/2023
Certification Date: 10/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13000 N MERIDIAN ST STE 101
CARMEL IN
46032-1404
US

IV. Provider business mailing address

13000 N MERIDIAN ST STE 101
CARMEL IN
46032-1404
US

V. Phone/Fax

Practice location:
  • Phone: 317-208-3855
  • Fax: 317-208-3847
Mailing address:
  • Phone: 317-208-3855
  • Fax: 317-208-3847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71001995A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71001995A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: