Provider Demographics
NPI:1982885539
Name:BURKE, BRIDGET ANNE (DNP)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:ANNE
Last Name:BURKE
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:ANNE
Other - Last Name:DULL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-643-6400
Mailing Address - Fax:515-643-5816
Practice Address - Street 1:411 LAUREL ST STE 3250
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3026
Practice Address - Country:US
Practice Address - Phone:515-643-6400
Practice Address - Fax:515-643-5816
Is Sole Proprietor?:No
Enumeration Date:2007-11-23
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA107282363L00000X
IAL-107282363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner