Healthcare Provider Details

I. General information

NPI: 1699242792
Provider Name (Legal Business Name): ALEXANDRA BURKART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2018
Last Update Date: 11/04/2022
Certification Date: 11/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

5 ALBION LN
CINCINNATI OH
45246-4701
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8922
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number415423
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number019816
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: