Doctor Name: | JULIE INEZ BURKE |
NPI Number: | 1366797391 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PMH/CNS |
License Number: | RN126100 |
Business Practice Address: | 690 Dallas Hwy Suite 201 Villa Rica, GA - 301801264 |
Business Phone Number: | 6788408446 |
Business Fax Number: | 6788408482 |
Mailing Address: | 690 Dallas Hwy, Suite 201 VILLA RICA |
State: | GA |
Postal Code: | 301801264 |
Phone Number: | 6788408446 |
Fax Number: | 6788408482 |
NPI Enumeration Date: | 07/16/2012 |
NPI Last Update Date: | 07/16/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SP0809X |
License Number: | RN126100 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Psych/Mental Health, Adult |
Taxonomy Definition: |