Provider Demographics
NPI:1760047260
Name:BURKS, KRISTIE YVONNE (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTIE
Middle Name:YVONNE
Last Name:BURKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTIE
Other - Middle Name:YVONNE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:510 CHERRY STREET
Mailing Address - Street 2:BUIDLING A, STE 206
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701
Mailing Address - Country:US
Mailing Address - Phone:276-322-4661
Mailing Address - Fax:276-322-2442
Practice Address - Street 1:510 CHERRY STREET
Practice Address - Street 2:BUIDLING A, STE 206
Practice Address - City:BLUEFIELD
Practice Address - State:WV
Practice Address - Zip Code:24701
Practice Address - Country:US
Practice Address - Phone:276-322-4661
Practice Address - Fax:276-322-2442
Is Sole Proprietor?:No
Enumeration Date:2019-05-09
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV32475208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics