Provider Demographics
NPI:1447422712
Name:BURKS, CRISTINA M (APN)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:M
Last Name:BURKS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 STONEHOLLOW WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-4571
Mailing Address - Country:US
Mailing Address - Phone:615-872-9966
Mailing Address - Fax:
Practice Address - Street 1:5651 FRIST BLVD 712
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2061
Practice Address - Country:US
Practice Address - Phone:615-872-9966
Practice Address - Fax:615-872-9967
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000012864363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily