Provider Demographics
NPI:1740358381
Name:BURKEEN, CHRISTINE PAULA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:PAULA
Last Name:BURKEEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:CHRISTINE
Other - Middle Name:PAULA
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:16263 LINDEN CT
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-4406
Mailing Address - Country:US
Mailing Address - Phone:615-804-7248
Mailing Address - Fax:
Practice Address - Street 1:4200 WHITEHALL DR STE 150
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9694
Practice Address - Country:US
Practice Address - Phone:734-995-0308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1456363A00000X
MI5601008428363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00906799OtherRAILROAD MEDICARE
TN103I972851Medicare PIN
TN103I972848Medicare PIN
TN103I973707Medicare PIN
TN103I972852Medicare PIN