MEDICARE: MRS. DORIS FAYE BURKEY MSN, CFNP

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
1	363LF0000X	Family Nurse Practitioner	R128855	MD
2	363LF0000X	Family Nurse Practitioner	40587	WV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	211828	OTHER	MD	MEDICARE FQHC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144464900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DORIS FAYE BURKEY MSN, CFNP

Provider Business Mailing Address
First Line	:	3774 VALLEY RD STE 101
Second Line	:
City	:	BERKELEY SPRINGS
State	:	WV
Zip	:	25411-4614
Country	:	US
Telephone Number	:	304-258-9433
Fax Number	:	304-258-6063

Provider Business Practice Location Address
First Line	:	3774 VALLEY RD STE 101
Second Line	:
City	:	BERKELEY SPRINGS
State	:	WV
Zip	:	25411-4614
Country	:	US
Telephone Number	:	130-425-8943
Fax Number	:	304-258-6063

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2009
Last Update Date	:	04/19/2022

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