Healthcare Provider Details

I. General information

NPI: 1215778394
Provider Name (Legal Business Name): ERIN LYNN BURCH MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 MORRISON
MORRISON OK
73061-9415
US

IV. Provider business mailing address

207 MORRISON
MORRISON OK
73061-9415
US

V. Phone/Fax

Practice location:
  • Phone: 615-995-0576
  • Fax:
Mailing address:
  • Phone: 615-995-0576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR0125812
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: