Sidne Burke, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Kennett, MO
NPI 1104762129 · NPPES record last updated Apr 24, 2026
Key facts
- NPI
- 1104762129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2026016933 (MO)
- Practice address
- 1124 Independence Ave
Kennett, MO 63857-1314 - Phone
- (573) 888-5892
- NPI assigned
- Apr 24, 2026
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Visiting Nurse Association of Southeast Missouri Inc
Practice addresses (Care Compare)
Kennett, MO 63857
Phone (573) 888-5892
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260611003824 | MO | Practitioner - Nurse Practitioner | 7416429378 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2026016933 | MO | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2026016933 | MO | Yes |
Addresses
Primary practice location
1124 Independence Ave
Kennett, MO 63857-1314
Mailing address
1417 Gunner Reed Rd
Kennett, MO 63857-8391
Other providers in Kennett, MO
- Dana Renee Brunk
- Desiree D Buchanan
- Christina Burch
- Burcham Dental Arts Clinic
- Britt D. Burcham
- Alyssa A Burkman
- Ariel Burleson
- Brooke Burlison
- Garron Daniel Burlison
- Kimberly Lynette Burns
All providers in Kennett, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.