Healthcare Provider Details

I. General information

NPI: 1376426023
Provider Name (Legal Business Name): BROOKE ELIZABETH BURKETT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 MAYSVILLE RD
MOUNT STERLING KY
40353-9464
US

IV. Provider business mailing address

PO BOX 936
LONDON KY
40743-0936
US

V. Phone/Fax

Practice location:
  • Phone: 859-398-2100
  • Fax: 859-398-2106
Mailing address:
  • Phone: 606-330-7835
  • Fax: 859-398-2106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: