Provider Demographics
NPI:1811306764
Name:BURKETT, DINA MARIE (APRN,FNP-BC,PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:DINA
Middle Name:MARIE
Last Name:BURKETT
Suffix:
Gender:F
Credentials:APRN,FNP-BC,PMHNP-BC
Other - Prefix:MRS
Other - First Name:DINA
Other - Middle Name:MARIE
Other - Last Name:MASTEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2438 MONARCH DR STE A-375
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-6605
Mailing Address - Country:US
Mailing Address - Phone:956-523-0966
Mailing Address - Fax:
Practice Address - Street 1:2438 MONARCH DR STE A-375
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-6605
Practice Address - Country:US
Practice Address - Phone:956-523-0966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126058363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP126058OtherLICENSE