Provider Demographics
NPI:1891533790
Name:BURKE, ERIN CLARE (PA-C, EMT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:CLARE
Last Name:BURKE
Suffix:
Gender:F
Credentials:PA-C, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 TIMBER EDGE DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-5484
Mailing Address - Country:US
Mailing Address - Phone:972-838-8634
Mailing Address - Fax:
Practice Address - Street 1:120 HOSPITAL DR STE 100
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:MO
Practice Address - Zip Code:65536-9227
Practice Address - Country:US
Practice Address - Phone:417-533-6751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA17801363A00000X
MO2024028263363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant