Provider Demographics
NPI:1750449500
Name:BURKE, VELMA JEAN (APRN BC GNP)
Entity Type:Individual
Prefix:MRS
First Name:VELMA
Middle Name:JEAN
Last Name:BURKE
Suffix:
Gender:F
Credentials:APRN BC GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3697 MISER STATION RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37777-3510
Mailing Address - Country:US
Mailing Address - Phone:865-983-2812
Mailing Address - Fax:865-981-2836
Practice Address - Street 1:1012 JAMESTOWN WAY
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37803-5865
Practice Address - Country:US
Practice Address - Phone:865-984-1600
Practice Address - Fax:865-238-8308
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4776990363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3341803Medicaid
S81087Medicare UPIN
3341803Medicare ID - Type Unspecified