Doctor Name: | JODI BURHENN |
NPI Number: | 1235516881 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 4081 W State Road 234 Mccordsville, IN - 460559318 |
Business Phone Number: | 3176013294 |
Business Fax Number: | |
Mailing Address: | 4081 W State Road 234, MCCORDSVILLE |
State: | IN |
Postal Code: | 460559318 |
Phone Number: | 3176013294 |
Fax Number: | |
NPI Enumeration Date: | 05/04/2015 |
NPI Last Update Date: | 05/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 246ZE0600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Specialist/Technologist, Other |
Taxonomy Specialization: | Electroneurodiagnostic |
Taxonomy Definition: |