Healthcare Provider Details

I. General information

NPI: 1841455318
Provider Name (Legal Business Name): JULIE HATCH BURK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2008
Last Update Date: 01/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 E 10TH ST BRICKIE COMMUNITY HEALTH CLINIC
HOBART IN
46342-5313
US

IV. Provider business mailing address

2211 E 10TH ST BRICKIE COMMUNITY HEALTH CLINIC
HOBART IN
46342-5313
US

V. Phone/Fax

Practice location:
  • Phone: 219-945-9383
  • Fax: 219-945-9384
Mailing address:
  • Phone: 219-945-9383
  • Fax: 219-945-9384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71002630A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: