Provider Demographics
NPI:1194432864
Name:BURDS FAMILY PRACTICE
Entity type:Organization
Organization Name:BURDS FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BURDS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:563-451-3273
Mailing Address - Street 1:10768 COX SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:PEOSTA
Mailing Address - State:IA
Mailing Address - Zip Code:52068-9649
Mailing Address - Country:US
Mailing Address - Phone:563-451-3273
Mailing Address - Fax:
Practice Address - Street 1:8411 PEOSTA COMMERCIAL CT
Practice Address - Street 2:
Practice Address - City:PEOSTA
Practice Address - State:IA
Practice Address - Zip Code:52068
Practice Address - Country:US
Practice Address - Phone:563-588-6659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-02
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center