Provider Demographics
NPI:1689781155
Name:HOWELL-BURKE, UNDINE JEAN (MD)
Entity Type:Individual
Prefix:
First Name:UNDINE
Middle Name:JEAN
Last Name:HOWELL-BURKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8055 O ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2564
Mailing Address - Country:US
Mailing Address - Phone:402-421-0904
Mailing Address - Fax:402-421-0946
Practice Address - Street 1:555 S 70TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2462
Practice Address - Country:US
Practice Address - Phone:402-219-7930
Practice Address - Fax:402-219-7920
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE181932085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025009000Medicaid
NEP00119968OtherMEDICARE RAILROAD
NEP00716926Medicare PIN
NE10025009000Medicaid
NE098147035Medicare PIN
E67659Medicare UPIN