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General NPI Number Information
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NPI Number | 1659713634
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Entity Type | Individual
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Provider Name | TRACI ANNE BURKHART CNA, BSHA/LTC
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Gender | Female
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Dates
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Enumeration Date | 07/19/2013
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Last Update Date | 07/19/2013
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Provider Practice Location Address
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Address Line | 1000 E US HIGHWAY 54 SUITE D
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City | CAMDENTON
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State | MO
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Zip | 65020-6835
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Country | US
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Telephone | 573-693-8437
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 676
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City | CAMDENTON
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State | MO
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Zip | 65020-0676
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Country | US
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Telephone | 573-693-8437
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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