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General NPI Number Information
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NPI Number | 1811871080
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Entity Type | Individual
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Provider Name | KAYLA NICOLE BURKE PTA
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Gender | Female
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Dates
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Enumeration Date | 08/01/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 805 WEST ST
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City | WHITE HALL
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State | AR
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Zip | 71602-2949
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Country | US
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Telephone | 870-247-1988
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Fax |
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Provider Business Mailing Address
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Address Line | 717 INDIAN BAY DR
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City | SHERWOOD
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State | AR
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Zip | 72120-3458
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Country | US
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Telephone | 501-803-8968
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 5032
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License Number State | AR
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