Provider Demographics
NPI:1407964166
Name:BURR, KRISTEN NICOLE (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:NICOLE
Last Name:BURR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:SUKRAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5285
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68802-5285
Mailing Address - Country:US
Mailing Address - Phone:308-382-0344
Mailing Address - Fax:308-382-3241
Practice Address - Street 1:620 N DIERS AVE
Practice Address - Street 2:STE 300
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4984
Practice Address - Country:US
Practice Address - Phone:308-382-0344
Practice Address - Fax:308-382-3241
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2381174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist