Provider Demographics
NPI:1336144567
Name:BURTE, KERRIN D (MD)
Entity Type:Individual
Prefix:
First Name:KERRIN
Middle Name:D
Last Name:BURTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 LEGENDS WAY
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-2418
Mailing Address - Country:US
Mailing Address - Phone:859-331-3100
Mailing Address - Fax:859-331-9147
Practice Address - Street 1:2616 LEGENDS WAY
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-2418
Practice Address - Country:US
Practice Address - Phone:859-331-3100
Practice Address - Fax:859-331-9147
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY27107207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY660000297OtherRR MEDICARE
KY64271075Medicaid
KY660000297OtherRR MEDICARE
KYE67773Medicare UPIN