Provider Demographics
NPI:1255106472
Name:BURKE, BRITTANY MARIE (RN)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MARIE
Last Name:BURKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:BRITTANY
Other - Middle Name:M
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:102 MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-1919
Mailing Address - Country:US
Mailing Address - Phone:207-573-0270
Mailing Address - Fax:
Practice Address - Street 1:102 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1919
Practice Address - Country:US
Practice Address - Phone:207-573-0270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN66467163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory