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General NPI Number Information
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NPI Number | 1710665278
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Entity Type | Individual
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Provider Name | MELISSA BURKLE
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Gender | Female
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Dates
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Enumeration Date | 07/06/2023
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 17990 SPENCER RD
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City | PLEASANT VALLEY
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State | IA
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Zip | 52767-1205
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Country | US
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Telephone | 563-332-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 2615 SHEFFIELD DR
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City | DAVENPORT
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State | IA
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Zip | 52806-2620
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Country | US
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Telephone | 563-271-2450
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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 | A174278
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License Number State | IA
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