Provider Demographics
NPI:1861106726
Name:BURKARDT, SHELBY LEE (FNP)
Entity type:Individual
Prefix:MS
First Name:SHELBY
Middle Name:LEE
Last Name:BURKARDT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4381 N 24TH WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4970
Mailing Address - Country:US
Mailing Address - Phone:406-600-6135
Mailing Address - Fax:
Practice Address - Street 1:10245 E VIA LINDA STE 104
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5316
Practice Address - Country:US
Practice Address - Phone:480-568-4599
Practice Address - Fax:480-360-1951
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ217875363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily