Provider Demographics
NPI:1851700439
Name:BURKLEY, ANDREA (MS, RD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:BURKLEY
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4251 KIPLING ST UNIT 415
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6833
Mailing Address - Country:US
Mailing Address - Phone:614-546-7849
Mailing Address - Fax:
Practice Address - Street 1:4251 KIPLING ST UNIT 415
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6833
Practice Address - Country:US
Practice Address - Phone:614-546-7849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-07
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered