Provider Demographics
NPI:1407805583
Name:BURKHARDT, ANNEMARIE (MSN, APN,C)
Entity Type:Individual
Prefix:MR
First Name:ANNEMARIE
Middle Name:
Last Name:BURKHARDT
Suffix:
Gender:F
Credentials:MSN, APN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 BRENT CT
Mailing Address - Street 2:
Mailing Address - City:THOROFARE
Mailing Address - State:NJ
Mailing Address - Zip Code:08086-2000
Mailing Address - Country:US
Mailing Address - Phone:856-848-9491
Mailing Address - Fax:
Practice Address - Street 1:1925 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-6713
Practice Address - Country:US
Practice Address - Phone:609-441-2161
Practice Address - Fax:609-441-2163
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00015911363LF0000X
NJ26NR04635300363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2644903000OtherAMERIHEALTH
NJ60010273OtherHORIZON NJ HEALTH
NJ9118608Medicaid
NJP84271Medicare UPIN
NJ9118608Medicaid
NJ068145UKEMedicare PIN