Provider Demographics
NPI:1154866051
Name:BURKS, DARLENE
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:BURKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10801 W HIGHWAY 66 APT 177
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-3293
Mailing Address - Country:US
Mailing Address - Phone:405-436-9919
Mailing Address - Fax:
Practice Address - Street 1:10801 W HIGHWAY 66 APT 177
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-3293
Practice Address - Country:US
Practice Address - Phone:405-436-9919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-31
Last Update Date:2016-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management