MEDICARE: BRIDGET ANNE BURKE DNP

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	363L00000X	Nurse Practitioner	A107282	IA
2	363L00000X	Nurse Practitioner	L-107282	IA

General Provider Information

NPI Number	:	1982885539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIDGET ANNE BURKE DNP

Provider Business Mailing Address
First Line	:	PO BOX 1475
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50305-1475
Country	:	US
Telephone Number	:	515-643-6400
Fax Number	:	515-643-5816

Provider Business Practice Location Address
First Line	:	411 LAUREL ST STE 3250
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50314-3026
Country	:	US
Telephone Number	:	515-643-6400
Fax Number	:	515-643-5816

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

Provider Enumeration Date	:	11/23/2007
Last Update Date	:	12/29/2023

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