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Individual

AMANDA LIN BURKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AG-ACNP

Contact information

Practice address
1514 JEFFERSON HWY, JEFFERSON, LA 70121-2429
(504) 842-3000
Mailing address
1514 JEFFERSON HWY, JEFFERSON, LA 70121-2429
(504) 842-3000

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP08512
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02100758
MS
05
2403346
LA
Enumeration date
09/01/2015
Last updated
02/24/2016
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