Provider Demographics
NPI:1538486154
Name:BURCKHARD, ANDREA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MARIE
Last Name:BURCKHARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:MARIE
Other - Last Name:ALBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 WESTERN AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-3760
Mailing Address - Country:US
Mailing Address - Phone:701-838-2121
Mailing Address - Fax:
Practice Address - Street 1:700 WESTERN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-3760
Practice Address - Country:US
Practice Address - Phone:701-838-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5508111N00000X
ND1003111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor