Healthcare Provider Details

I. General information

NPI: 1740107762
Provider Name (Legal Business Name): MICHAEL BURCHETT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

298 CHRISTOPHER DR
RUSSELL SPRINGS KY
42642-6927
US

IV. Provider business mailing address

109 BROWN ST APT A
ALBANY KY
42602-1058
US

V. Phone/Fax

Practice location:
  • Phone: 859-398-1439
  • Fax:
Mailing address:
  • Phone: 859-398-1439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: