Healthcare Provider Details

I. General information

NPI: 1811654296
Provider Name (Legal Business Name): JEAN ANNE BURKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2021
Last Update Date: 11/20/2021
Certification Date: 11/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 BELMONT RD
WEST HARWICH MA
02671-1316
US

IV. Provider business mailing address

83 BELMONT RD
WEST HARWICH MA
02671-1316
US

V. Phone/Fax

Practice location:
  • Phone: 508-241-4366
  • Fax:
Mailing address:
  • Phone: 508-241-4366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: