Healthcare Provider Details

I. General information

NPI: 1447659289
Provider Name (Legal Business Name): TENA SUZANNE BURKE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2014
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 S LIMESTONE
LEXINGTON KY
40536-7001
US

IV. Provider business mailing address

740 S LIMESTONE
LEXINGTON KY
40536-0001
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-6494
  • Fax: 859-257-2573
Mailing address:
  • Phone: 859-323-6494
  • Fax: 859-257-2573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number3008839
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3008839
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: