Provider Demographics
NPI:1548779978
Name:BURKHARDT, KATRINIA L (NP)
Entity Type:Individual
Prefix:
First Name:KATRINIA
Middle Name:L
Last Name:BURKHARDT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-2427
Mailing Address - Country:US
Mailing Address - Phone:781-331-2000
Mailing Address - Fax:781-337-6104
Practice Address - Street 1:70 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-2427
Practice Address - Country:US
Practice Address - Phone:781-331-2000
Practice Address - Fax:781-331-2000
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN269591207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology