Provider Demographics
NPI:1710665138
Name:BURKHART, NORA ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NORA
Middle Name:ELIZABETH
Last Name:BURKHART
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:NORA
Other - Middle Name:ELIZABETH
Other - Last Name:PHELAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4750 E 450 S
Mailing Address - Street 2:
Mailing Address - City:WHITESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46075-8404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4750 E 450 S
Practice Address - Street 2:
Practice Address - City:WHITESTOWN
Practice Address - State:IN
Practice Address - Zip Code:46075-8404
Practice Address - Country:US
Practice Address - Phone:877-783-2262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26023287A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist