Provider Demographics
NPI:1083990121
Name:BURKE, LINDSAY REGNERY (MSN, PMHNP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:REGNERY
Last Name:BURKE
Suffix:
Gender:F
Credentials:MSN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 16TH ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-6325
Mailing Address - Country:US
Mailing Address - Phone:303-335-5783
Mailing Address - Fax:
Practice Address - Street 1:1621 16TH ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-6325
Practice Address - Country:US
Practice Address - Phone:312-485-1390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORXN.0100543-NP363LP0808X
COAPN.0990404-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health