Healthcare Provider Details
I. General information
NPI: 1396702890
Provider Name (Legal Business Name): JOANNE E BURG PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/27/2006
Last Update Date: 11/09/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 UNIVERSITY DR
HERSHEY PA
17033-2360
US
IV. Provider business mailing address
PO BOX 854 MC A410
HERSHEY PA
17033-0854
US
V. Phone/Fax
- Phone: 800-233-4082
- Fax:
- Phone: 800-233-4082
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | MA000591L |
| License Number State | PA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: