MEDICARE: KERSHA BURKE

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	RN306465	GA

General Provider Information

NPI Number	:	1992559058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERSHA BURKE

Provider Business Mailing Address
First Line	:	1401 HOSEA L WILLIAMS DR SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30317-1703
Country	:	US
Telephone Number	:	617-840-6189
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 HOSEA L WILLIAMS DR SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30317-1703
Country	:	US
Telephone Number	:	404-373-6614
Fax Number	:

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

Provider Enumeration Date	:	04/15/2024
Last Update Date	:	04/15/2024

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Directions to “ KERSHA BURKE ” Practice Location

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