| Doctor Name: | GRACE ELLEN BURKE |
| NPI Number: | 1760853436 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CFNP |
| License Number: | 20552 |
| Business Practice Address: | 110 Pioneer Way Magee, MS - 391115501 |
| Business Phone Number: | 6018496440 |
| Business Fax Number: | 6018491318 |
| Mailing Address: | 20445 Alberta St, ONEIDA |
| State: | TN |
| Postal Code: | 378413509 |
| Phone Number: | 4235692754 |
| Fax Number: | 4235692756 |
| NPI Enumeration Date: | 10/07/2015 |
| NPI Last Update Date: | 10/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 20552 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |