Provider Demographics
NPI:1881866960
Name:BURPO, REBECCA H (CNM)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:H
Last Name:BURPO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 W. MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013
Mailing Address - Country:US
Mailing Address - Phone:214-495-9911
Mailing Address - Fax:214-495-9918
Practice Address - Street 1:406 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2714
Practice Address - Country:US
Practice Address - Phone:214-495-9911
Practice Address - Fax:214-495-9918
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRN239415367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS85793OtherUPIN