Provider Demographics
NPI:1134264963
Name:BURKE, VICTORIA DYNDA (RN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:DYNDA
Last Name:BURKE
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9229 S KENNETH PL
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-3360
Mailing Address - Country:US
Mailing Address - Phone:480-820-1768
Mailing Address - Fax:480-783-4051
Practice Address - Street 1:8700 S KYRENE RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-2108
Practice Address - Country:US
Practice Address - Phone:480-783-4117
Practice Address - Fax:480-783-4051
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZRN082555363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics