Healthcare Provider Details

I. General information

NPI: 1205721198
Provider Name (Legal Business Name): MADISON BURKE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PLEASANT ST
CONCORD NH
03301-7559
US

IV. Provider business mailing address

5 SILVESTRI CIR UNIT 8
DERRY NH
03038-1337
US

V. Phone/Fax

Practice location:
  • Phone: 603-225-2711
  • Fax:
Mailing address:
  • Phone: 603-508-8892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number111794-21
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: