Provider Demographics
NPI:1649741539
Name:BURKEEN, JAIME MICHELLE (SAC-IT)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:MICHELLE
Last Name:BURKEEN
Suffix:
Gender:F
Credentials:SAC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 W BLUEMOUND RD
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-2787
Mailing Address - Country:US
Mailing Address - Phone:262-804-1200
Mailing Address - Fax:414-246-2524
Practice Address - Street 1:2000 W BLUEMOUND RD
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-2787
Practice Address - Country:US
Practice Address - Phone:262-804-1200
Practice Address - Fax:414-246-2524
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No171M00000XOther Service ProvidersCase Manager/Care Coordinator