Healthcare Provider Details
I. General information
NPI: 1235630260
Provider Name (Legal Business Name): ABBY A BURKE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/25/2018
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1055 DAVID DR
MORGAN CITY LA
70380-1317
US
IV. Provider business mailing address
1055 DAVID DR
MORGAN CITY LA
70380-1317
US
V. Phone/Fax
- Phone: 985-384-2430
- Fax:
- Phone: 985-384-2430
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | AP09903 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: