Provider Demographics
NPI:1508091612
Name:BURKHOLDER, KAREN ELAINE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ELAINE
Last Name:BURKHOLDER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:ELAINE
Other - Last Name:HAMPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:405 S HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-2434
Mailing Address - Country:US
Mailing Address - Phone:503-538-3919
Mailing Address - Fax:
Practice Address - Street 1:405 S HARRISON ST
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-2434
Practice Address - Country:US
Practice Address - Phone:505-538-3919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR087006634RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse