Provider Demographics
NPI:1427131143
Name:BURKE, CAYLA J (NP)
Entity type:Individual
Prefix:
First Name:CAYLA
Middle Name:J
Last Name:BURKE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13000 N MERIDIAN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1404
Mailing Address - Country:US
Mailing Address - Phone:317-208-3855
Mailing Address - Fax:317-208-3847
Practice Address - Street 1:13000 N MERIDIAN ST STE 101
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1404
Practice Address - Country:US
Practice Address - Phone:317-208-3855
Practice Address - Fax:317-208-3847
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001995A363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201135130Medicaid
IN716700031Medicare PIN