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NPI Code Detail

MEDICARE: JANE C BURKE CRNP

MEDICARE: JANE C BURKE CRNP
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
1363L00000XNurse PractitionerTP004504BPA

General Provider Information

NPI Number : 1124085089
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE C BURKE CRNP
Provider Business Mailing Address
First Line : PO BOX 369
Second Line :
City : ERIE
State : PA
Zip : 16512-0369
Country : US
Telephone Number : 814-454-4530
Fax Number :
Provider Business Practice Location Address
First Line : 1202 STATE ST
Second Line :
City : ERIE
State : PA
Zip : 16501-1914
Country : US
Telephone Number : 814-454-4530
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 04/15/2008

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Directions to “ JANE C BURKE CRNP” Practice Location

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