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General NPI Number Information
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NPI Number | 1245477819
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Entity Type | Individual
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Provider Name | JANE R BURCH PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/19/2009
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Last Update Date | 01/19/2009
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Provider Practice Location Address
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Address Line | 3511 BEMIS RD
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City | YPSILANTI
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State | MI
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Zip | 48197-9307
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Country | US
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Telephone | 734-434-2691
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Fax |
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Provider Business Mailing Address
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Address Line | 529 BURWOOD AVE
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City | ANN ARBOR
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State | MI
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Zip | 48103-3933
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Country | US
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Telephone | 734-665-5790
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601002982
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License Number State | MI
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