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General NPI Number Information
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NPI Number | 1013793694
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Entity Type | Individual
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Provider Name | ALEXIS GRACE BURKET CNP
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Gender | Female
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Dates
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Enumeration Date | 09/07/2023
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 1216 RYANS RD STE 3
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City | WORTHINGTON
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State | MN
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Zip | 56187-1781
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Country | US
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Telephone | 507-372-2921
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Fax |
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Provider Business Mailing Address
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Address Line | 2812 E BROME PL
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City | SIOUX FALLS
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State | SD
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Zip | 57108-5447
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Country | US
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Telephone | 605-641-1271
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | CP003564
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2474922
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License Number State | MN
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