Individual
MRS. RAVEN P BURKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
679 E COUNTY LINE RD, GREENWOOD, IN 46143-1049
(317) 859-7222
(317) 859-7220
Mailing address
679 E COUNTY LINE RD, GREENWOOD, IN 46143-1049
(317) 859-7222
(317) 859-7220
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
28195639A
IN
363L00000X
Nurse Practitioner
71009712A
IN
363LF0000X
Family Nurse Practitioner
Primary
71009712A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487680518
GROUP NPI
—
01
—
28195639A
INDIANA STATE BOARD OF NURSING
IN
Enumeration date
01/24/2019
Last updated
02/13/2024
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