Provider Demographics
NPI:1508043241
Name:BURKE, CYNTHIA (LPN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:BURKE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:13103 HAMPTON CLUB DR
Mailing Address - Street 2:#102
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-7427
Mailing Address - Country:US
Mailing Address - Phone:440-503-2331
Mailing Address - Fax:
Practice Address - Street 1:13103 HAMPTON CLUB DR
Practice Address - Street 2:#102
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-7427
Practice Address - Country:US
Practice Address - Phone:440-503-2331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH115880164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse