Healthcare Provider Details

I. General information

NPI: 1043557382
Provider Name (Legal Business Name): ABIGAIL TUCKER BURKA RPH, PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2013
Last Update Date: 12/17/2019
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 UNIVERSITY PARK DR DEPT OF PHARMACY PRACTICE
NASHVILLE TN
37204-3956
US

IV. Provider business mailing address

1 UNIVERSITY PARK DR DEPT OF PHARMACY PRACTICE
NASHVILLE TN
37204-3956
US

V. Phone/Fax

Practice location:
  • Phone: 615-966-7191
  • Fax:
Mailing address:
  • Phone: 615-966-7191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number34307
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number34307
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: