Provider Demographics
NPI:1194208009
Name:BURKHART, JANELLE CAROL
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:CAROL
Last Name:BURKHART
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 1:13194 E PARKER LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MONROE CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47557-7203
Mailing Address - Country:US
Mailing Address - Phone:812-881-9796
Mailing Address - Fax:
Practice Address - Street 1:1109 E NATIONAL HWY
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501-4128
Practice Address - Country:US
Practice Address - Phone:812-254-7159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist