Provider Demographics
NPI:1417655945
Name:BURKS LANKFORD, KYIA
Entity Type:Individual
Prefix:
First Name:KYIA
Middle Name:
Last Name:BURKS LANKFORD
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 1:2112 BROADWAY ST NE STE 225
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-3081
Mailing Address - Country:US
Mailing Address - Phone:612-643-9336
Mailing Address - Fax:
Practice Address - Street 1:2112 BROADWAY ST NE STE 225
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-3081
Practice Address - Country:US
Practice Address - Phone:612-643-9336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy