Provider Demographics
NPI:1861786162
Name:BURK, ABBIE M (NP)
Entity type:Individual
Prefix:
First Name:ABBIE
Middle Name:M
Last Name:BURK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ABBIE
Other - Middle Name:M
Other - Last Name:WERMERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4623 WESLEY AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2246
Mailing Address - Country:US
Mailing Address - Phone:513-841-1122
Mailing Address - Fax:513-366-4432
Practice Address - Street 1:4623 WESLEY AVE
Practice Address - Street 2:SUITE C
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2246
Practice Address - Country:US
Practice Address - Phone:513-841-1122
Practice Address - Fax:513-366-4432
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.12363363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner