Provider Demographics
NPI:1548053994
Name:BURKHALTER, LAUREN ANN
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ANN
Last Name:BURKHALTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5026 GREYFIELD PL N
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31605-7087
Mailing Address - Country:US
Mailing Address - Phone:404-394-0622
Mailing Address - Fax:404-394-0622
Practice Address - Street 1:235 PARKS MEMORIAL BUILDING
Practice Address - Street 2:CBX 063
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061
Practice Address - Country:US
Practice Address - Phone:478-445-1076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN314477163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse