Provider Demographics
NPI:1336242775
Name:BURKLEY, CARRIE A (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:A
Last Name:BURKLEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:CARRIE
Other - Middle Name:A
Other - Last Name:OFFMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:20820 ROUTE 19
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-6006
Mailing Address - Country:US
Mailing Address - Phone:412-432-7909
Mailing Address - Fax:412-202-2304
Practice Address - Street 1:20820 ROUTE 19
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-6006
Practice Address - Country:US
Practice Address - Phone:412-432-7909
Practice Address - Fax:412-202-2304
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP004532B363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
641027OtherBLUE SHIELD
S45023Medicare UPIN
641027OtherBLUE SHIELD