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NPI Code Detail

MEDICARE: KATHLEEN MARIE BURKE PA-C

MEDICARE: KATHLEEN MARIE BURKE PA-C
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
1363A00000XPhysician Assistant1257023WI

General Provider Information

NPI Number : 1144291063
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN MARIE BURKE PA-C
Provider Business Mailing Address
First Line : 6213 MASTHEAD DR
Second Line :
City : MADISON
State : WI
Zip : 53705-4323
Country : US
Telephone Number : 262-308-4083
Fax Number :
Provider Business Practice Location Address
First Line : 2500 OVERLOOK TER
Second Line :
City : MADISON
State : WI
Zip : 53705-2254
Country : US
Telephone Number : 608-256-1901
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2006
Last Update Date : 05/02/2012

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Directions to “ KATHLEEN MARIE BURKE PA-C” Practice Location

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