Provider Demographics
NPI:1497018741
Name:BURKMAN, ASHLEY RENEE (ND)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:RENEE
Last Name:BURKMAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8228
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040
Mailing Address - Country:US
Mailing Address - Phone:860-533-8017
Mailing Address - Fax:860-812-2025
Practice Address - Street 1:315 EAST CENTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040
Practice Address - Country:US
Practice Address - Phone:860-533-8017
Practice Address - Fax:860-812-2025
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00483175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath