Provider Demographics
NPI:1376646646
Name:BURKS, PATSY J (APN)
Entity type:Individual
Prefix:MRS
First Name:PATSY
Middle Name:J
Last Name:BURKS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 647
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-0647
Mailing Address - Country:US
Mailing Address - Phone:931-766-0433
Mailing Address - Fax:931-766-5021
Practice Address - Street 1:609 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-2420
Practice Address - Country:US
Practice Address - Phone:931-766-0433
Practice Address - Fax:931-766-5021
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5192363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3374553OtherMEDICAID PROVIDER NUMBER
TN1376646646OtherNPI - PAT BURKS
TN1376646646OtherNPI - PAT BURKS
TN1376646646OtherNPI - PAT BURKS
TN3374553OtherMEDICAID PROVIDER NUMBER