Provider Demographics
NPI:1215581590
Name:BURKART, STEPHANIE T (CNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:T
Last Name:BURKART
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:568 S CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8970
Mailing Address - Country:US
Mailing Address - Phone:614-895-3344
Mailing Address - Fax:614-895-3795
Practice Address - Street 1:568 S CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8970
Practice Address - Country:US
Practice Address - Phone:614-895-3344
Practice Address - Fax:614-895-3795
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024786363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily