Provider Demographics
NPI:1417674904
Name:BURNHAM, DENISE (MS, BS, AS, CPC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:BURNHAM
Suffix:
Gender:F
Credentials:MS, BS, AS, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1961 W VIENNA AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53206-1913
Mailing Address - Country:US
Mailing Address - Phone:414-916-5403
Mailing Address - Fax:
Practice Address - Street 1:1961 W VIENNA AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53206-1913
Practice Address - Country:US
Practice Address - Phone:414-916-5403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator