Healthcare Provider Details

I. General information

NPI: 1750174025
Provider Name (Legal Business Name): KRISTINA ANN BURK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 SPRING ARBOR RD STE 100
JACKSON MI
49203-3799
US

IV. Provider business mailing address

3101 SPRING ARBOR RD STE 100
JACKSON MI
49203-3799
US

V. Phone/Fax

Practice location:
  • Phone: 517-782-2442
  • Fax: 517-782-0310
Mailing address:
  • Phone: 517-782-2442
  • Fax: 517-782-0310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: