Provider Demographics
NPI:1982747713
Name:BURD, ANN MARGARET (MPT)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:MARGARET
Last Name:BURD
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MS
Other - First Name:ANN
Other - Middle Name:MARGARET
Other - Last Name:JANSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPT
Mailing Address - Street 1:3838 12TH AVE N
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-2931
Mailing Address - Country:US
Mailing Address - Phone:701-234-4700
Mailing Address - Fax:
Practice Address - Street 1:3838 12TH AVE N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2931
Practice Address - Country:US
Practice Address - Phone:701-234-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1181225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist