Jessica Burke

Individual provider Active NPI Licensed Practical Nurse · Pedro, OH

NPI 1922480268 · NPPES record last updated Jun 23, 2015

Key facts

NPI
1922480268
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN.112008-MEDS (OH)
Practice address
115 Private Road 977
Pedro, OH 45659-8608
Phone
(740) 534-1386
Fax
(740) 534-1497
NPI assigned
Jun 23, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN.112008-MEDSOHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN.112008-MEDS OH Yes

Addresses

Primary practice location

115 Private Road 977
Pedro, OH 45659-8608

Mailing address

115 Private Road 977
Pedro, OH 45659-8608
Phone (740) 534-1386

Other providers in Pedro, OH

All providers in Pedro, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.