=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821808403
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRITTANY BURKE CNM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/07/2025
-----------------------------------------------------
Last Update Date | 01/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 640 LIBERTY ST
-----------------------------------------------------
City | PENN YAN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14527-1035
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-683-0650
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 295 STATE ROUTE 247
-----------------------------------------------------
City | RUSHVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14544-9646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-683-0650
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 176B00000X
-----------------------------------------------------
Taxonomy Name | Midwife
-----------------------------------------------------
License Number | 002370
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------