Provider Demographics
NPI:1720559537
Name:BURKE, RACHEL OWENS (FNP)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:OWENS
Last Name:BURKE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 208
Mailing Address - Street 2:
Mailing Address - City:NICKELSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24271-0208
Mailing Address - Country:US
Mailing Address - Phone:276-479-3171
Mailing Address - Fax:
Practice Address - Street 1:17285 VETERANS MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:DUNGANNON
Practice Address - State:VA
Practice Address - Zip Code:24245-3937
Practice Address - Country:US
Practice Address - Phone:276-467-2201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-06
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000025130363LF0000X
VA0024176903363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health