Healthcare Provider Details

I. General information

NPI: 1558552372
Provider Name (Legal Business Name): SUSAN DODDS BURKE RNBSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 08/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 N MAIN ST
CHALFONT PA
18914-2916
US

IV. Provider business mailing address

PO BOX 242 7362 SHAD LANE
POINT PLEASANT PA
18950-0242
US

V. Phone/Fax

Practice location:
  • Phone: 215-822-3113
  • Fax:
Mailing address:
  • Phone: 215-297-8873
  • Fax: 215-297-8873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0600X
TaxonomyInfection Control Registered Nurse
License NumberRN235020L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: