Individual
MISS JORDAN RAE BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
11943 EL CAMINO REAL STE 100, SAN DIEGO, CA 92130-2597
(858) 249-3223
Mailing address
11943 EL CAMINO REAL STE 100, SAN DIEGO, CA 92130-2597
(858) 259-3223
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95014546
CA
363LF0000X
Family Nurse Practitioner
11005599
FL
Other
Enumeration date
01/08/2020
Last updated
08/22/2020
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