Provider Demographics
NPI:1467283671
Name:BURK, NICOLE ISABEL (FNP-C)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:ISABEL
Last Name:BURK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:ISABEL
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1620 S PADRE ISLAND DR STE 600
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78416-1366
Mailing Address - Country:US
Mailing Address - Phone:361-206-0737
Mailing Address - Fax:
Practice Address - Street 1:1620 S PADRE ISLAND DR STE 600
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78416-1366
Practice Address - Country:US
Practice Address - Phone:361-206-0737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1171034363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily