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General NPI Number Information
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NPI Number | 1669850384
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Entity Type | Individual
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Provider Name | MICHELLE BURKS APRN
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Gender | Female
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Dates
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Enumeration Date | 05/14/2015
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 1000 E MAIN ST
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City | BLYTHEVILLE
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State | AR
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Zip | 72315-2531
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Country | US
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Telephone | 870-409-7060
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Fax |
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Provider Business Mailing Address
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Address Line | 4196 HIGHWAY 62 412 STE A
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City | HARDY
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State | AR
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Zip | 72542-8002
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 227773
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License Number State | AR
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