Provider Demographics
NPI:1003128216
Name:BURKETT, ELAINE (CRNA)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:BURKETT
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:
Other - Last Name:DOBISZEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:2 READS WAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720
Mailing Address - Country:US
Mailing Address - Phone:302-709-4547
Mailing Address - Fax:302-709-4551
Practice Address - Street 1:2 READS WAY
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-1607
Practice Address - Country:US
Practice Address - Phone:302-709-4706
Practice Address - Fax:302-709-4551
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0021160367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered