Provider Demographics
NPI:1750510731
Name:BURGE, BRENDA KAY (PA-C)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:KAY
Last Name:BURGE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 104
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:SD
Mailing Address - Zip Code:57043-0104
Mailing Address - Country:US
Mailing Address - Phone:605-648-3418
Mailing Address - Fax:
Practice Address - Street 1:2701 S MINNESOTA AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-4744
Practice Address - Country:US
Practice Address - Phone:605-339-3378
Practice Address - Fax:605-339-0710
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant