Provider Demographics
NPI:1609030022
Name:BURKE, ABIGAIL S (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:S
Last Name:BURKE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 SANGAMORE RD STE S207
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-2529
Mailing Address - Country:US
Mailing Address - Phone:202-684-7167
Mailing Address - Fax:
Practice Address - Street 1:4701 SANGAMORE RD STE S207
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-2529
Practice Address - Country:US
Practice Address - Phone:202-684-7167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1007488363LF0000X
VA0024167750363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily