Provider Demographics
NPI:1477881076
Name:BURKE, CAITLIN A (LPN)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:A
Last Name:BURKE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14445-1304
Mailing Address - Country:US
Mailing Address - Phone:585-264-9681
Mailing Address - Fax:
Practice Address - Street 1:226 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:EAST ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14445-1304
Practice Address - Country:US
Practice Address - Phone:585-264-9681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299406164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse