Individual
NICOLE M BURKEMPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1225 S GRAND BLVD FL 3, SAINT LOUIS, MO 63104-1016
(314) 977-3400
(314) 977-7613
Mailing address
1008 S SPRING AVE FL 3, SAINT LOUIS, MO 63110-2520
(314) 977-1771
(317) 977-1802
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2006009409
MO
207N00000X
Dermatology Physician
44829
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
530633700
—
MN
Enumeration date
01/18/2006
Last updated
05/27/2025
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