Provider Demographics
NPI:1992300172
Name:BURKHARDT, KATHY LYNN
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:LYNN
Last Name:BURKHARDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 E CHICAGO RD
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-8424
Mailing Address - Country:US
Mailing Address - Phone:517-227-2699
Mailing Address - Fax:517-924-1129
Practice Address - Street 1:129 E CHICAGO RD
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-8424
Practice Address - Country:US
Practice Address - Phone:517-227-2699
Practice Address - Fax:517-924-1129
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health