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Individual

DR. LAURA BURKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
2021 LYNNHAVEN PKWY, SUITE A, VIRGINIA BEACH, VA 23456-1410
(757) 471-4040
(757) 471-4077
Mailing address
2021 LYNNHAVEN PKWY, SUITE A, VIRGINIA BEACH, VA 23456-1410
(757) 471-4040
(757) 471-4077

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001134
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010275792
VA
01
295922
MAMSI
VA
01
345981
BLUE CROSS BLUE SHIELD
VA
01
54-2058185
TAX ID
VA
Enumeration date
12/07/2006
Last updated
06/11/2008
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