Healthcare Provider Details

I. General information

NPI: 1326531591
Provider Name (Legal Business Name): MERRI A BURKE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MERRI A BURKE RN

II. Dates (important events)

Enumeration Date: 06/12/2018
Last Update Date: 06/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10234 MARION PARK DR
KANSAS CITY MO
64137-1405
US

IV. Provider business mailing address

4401 W 74TH TER
PRAIRIE VILLAGE KS
66208-2962
US

V. Phone/Fax

Practice location:
  • Phone: 816-201-3254
  • Fax:
Mailing address:
  • Phone: 913-406-9341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number1373882051
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: