Provider Demographics
NPI:1952309734
Name:BURKARDT, BARBARA L (CNM)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:L
Last Name:BURKARDT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:LYNN
Other - Last Name:TOBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR
Mailing Address - Street 2:PO BOX 0446 LOBBY J
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:4200 WHITEHALL DR
Practice Address - Street 2:STE 330
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-1142
Practice Address - Country:US
Practice Address - Phone:734-572-9600
Practice Address - Fax:734-222-3100
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH07526176B00000X
MIL162890367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H11898OtherBCBS OF MI
MI0H11898OtherBCBS OF MI
MI0M32470Medicare PIN
OH344428256OtherHEALTHNET
OH12680Medicare UPIN
OH000000064889OtherANTHEM
OH2454866Medicaid
OH75861Medicare PIN