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General NPI Number Information
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NPI Number | 1528067568
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Entity Type | Individual
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Provider Name | MARY ELIZABETH BURKETT CFNP
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Gender | Female
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 01/27/2009
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Provider Practice Location Address
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Address Line | 1360 N SAINT HELEN RD
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City | SAINT HELEN
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State | MI
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Zip | 48656-9521
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Country | US
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Telephone | 989-389-4944
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Fax | 989-389-1401
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Provider Business Mailing Address
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Address Line | 1360 N SAINT HELEN RD P O BOX 39
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City | SAINT HELEN
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State | MI
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Zip | 48656-9521
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Country | US
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Telephone | 989-389-4944
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Fax | 989-389-1401
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704110149
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License Number State | MI
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