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Individual

MR. MITCHELL R BURKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.N.

Contact information

Practice address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
Mailing address
1640 MEADOWLANE AVE, MOUNT PLEASANT, WI 53406-4634
(262) 344-4441

Taxonomy

Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
176150-30
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
176150-30
WISCONSIN DRL
WI
Enumeration date
05/21/2015
Last updated
05/21/2015
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