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General NPI Number Information
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NPI Number | 1346852019
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Entity Type | Individual
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Provider Name | KELLY BURKE NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 08/23/2020
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 1 WASHINGTON ST
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City | TAUNTON
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State | MA
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Zip | 02780-3960
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Country | US
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Telephone | 150-882-2550
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Fax |
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Provider Business Mailing Address
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Address Line | 1 WASHINGTON ST
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City | TAUNTON
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State | MA
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Zip | 02780-3960
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Country | US
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Telephone | 508-822-5500
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Fax | 508-822-5501
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | RN2283637
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License Number State | MA
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