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General NPI Number Information
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NPI Number | 1821169590
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Entity Type | Individual
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Provider Name | MARY CATHERINE BURKHART-GORDON ARNP
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Gender | Female
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 4105 BRIARGATE PKWY STE 205
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-3484
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Country | US
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Telephone | 719-886-6704
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Fax | 877-550-2140
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Provider Business Mailing Address
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Address Line | 2451 E BASELINE RD
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City | GILBERT
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State | AZ
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Zip | 85234-2471
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Country | US
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Telephone | 480-494-2770
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Fax | 480-494-2771
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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 | 207906
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP4675
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | C-APN.0103531-C-NP
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License Number State | CO
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