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Individual

KIM BURDICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHCNP

Contact information

Practice address
122 W COLORADO BLVD, DALLAS, TX 75208-2382
(214) 947-6700
(214) 947-6701
Mailing address
122 W COLORADO BLVD, DALLAS, TX 75208-2382
(214) 947-6700
(214) 947-6701

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
AP109765
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
042494702
TX
05
042494703
TX
05
042494704
TX
05
042494705
TX
05
042494706
TX
05
042494707
TX
05
042494708
TX
05
042494709
TX
05
042494710
TX
05
042494711
TX
01
8Y2093
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/10/2007
Last updated
05/03/2021
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