Doctor Name: | MS. LAURIE POWELL BURKE |
NPI Number: | 1013904374 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N., N.P., C.S. |
License Number: | 0024166500 |
Business Practice Address: | 13506 East Boundary Road Suite A Midlothian, VA - 231123989 |
Business Phone Number: | 8047446714 |
Business Fax Number: | 8047441265 |
Mailing Address: | 13506 East Boundary Road, Suite A MIDLOTHIAN |
State: | VA |
Postal Code: | 231123989 |
Phone Number: | 8047446714 |
Fax Number: | 8047441265 |
NPI Enumeration Date: | 10/03/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | 0024166500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |