Healthcare Provider Details

I. General information

NPI: 1609280528
Provider Name (Legal Business Name): COURTNEY BURKE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 SILER RD BLDG A
SANTA FE NM
87507-3540
US

IV. Provider business mailing address

1301 SILER RD BLDG A
SANTA FE NM
87507-3540
US

V. Phone/Fax

Practice location:
  • Phone: 505-476-8350
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00008156
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: