Sandra Burke
Individual provider Active NPI Nurse's Aide · Franklin, OH
NPI 1104238062 · NPPES record last updated May 27, 2014
Key facts
- NPI
- 1104238062
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- License
- 400019310901 (OH)
- Practice address
- 3641 Madison Grace Way
Franklin, OH 45005-9451 - Phone
- (937) 732-2456
- NPI assigned
- May 27, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 400019310901 | OH | MD | Nurse's Aide |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 400019310901 | OH | Yes |
Addresses
Primary practice location
3641 Madison Grace Way
Franklin, OH 45005-9451
Mailing address
3641 Madison Grace Way
Franklin, OH 45005-9451
Phone (937) 732-2456
Other providers in Franklin, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.