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NPI Code Detail

MEDICARE: NATALIE KAREN BURKS FNP

MEDICARE:   NATALIE KAREN BURKS  FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner250616TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DD8367OTHERTXRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3752774693OTHERTXTAX ID
41053304626OTHERNPI

General Provider Information

NPI Number : 1053304626
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATALIE KAREN BURKS FNP
Provider Business Mailing Address
First Line : PO BOX 817
Second Line :
City : PALESTINE
State : TX
Zip : 75802-0817
Country : US
Telephone Number : 903-727-0110
Fax Number : 903-727-0210
Provider Business Practice Location Address
First Line : 100 WILLOW CREEK PKWY
Second Line : SUITE C
City : PALESTINE
State : TX
Zip : 75801-4383
Country : US
Telephone Number : 903-723-8210
Fax Number : 903-723-8310
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2005
Last Update Date : 09/17/2008

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Directions to “ NATALIE KAREN BURKS FNP” Practice Location

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