Individual
LISA A BURK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1501 9TH AVE, CONWAY, SC 29526-4107
(843) 248-0104
Mailing address
1501 9TH AVE, CONWAY, SC 29526-4107
(843) 248-0104
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26162
SC
363LA2200X
Adult Health Nurse Practitioner
6279
CT
Other
Enumeration date
09/15/2015
Last updated
10/03/2023
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