Healthcare Provider Details

I. General information

NPI: 1518761303
Provider Name (Legal Business Name): KATIE NETTESHEIM BURKEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATIE COLEEN NETTESHEIM

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SENTARA CIR STE 105
WILLIAMSBURG VA
23188-5727
US

IV. Provider business mailing address

1901 CAPERS AVE APT 100
NASHVILLE TN
37212-3117
US

V. Phone/Fax

Practice location:
  • Phone: 757-253-5653
  • Fax:
Mailing address:
  • Phone: 262-822-6327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number0024196118
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: