Healthcare Provider Details

I. General information

NPI: 1043173941
Provider Name (Legal Business Name): JANE BURKE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CREIGHTON ST APT 3
JAMAICA PLAIN MA
02130-1213
US

IV. Provider business mailing address

10 CREIGHTON ST APT 3
JAMAICA PLAIN MA
02130-1213
US

V. Phone/Fax

Practice location:
  • Phone: 303-501-7327
  • Fax:
Mailing address:
  • Phone: 303-501-7327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN10014067
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: