Gordon, Mary Burkhart
Gordon, Mary Burkhart is an individual health care provider with primary practice located at 1701 Renaissance Blvd , Edmond OK 73013-3086. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Gordon, Mary Burkhart can be contacted via phone (405) 844-4978.Contact Information
Primary practice address
1701 Renaissance Blvd
Edmond OK 73013-3086
Phone: (405) 844-4978
Fax: (405) 844-0562
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 45190 | Kansas |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 207906 | Oklahoma |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 95000713 | California |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | AP4675 | Arizona |
Profile Details
| NPI number | 1821169590 |
|---|---|
| LBN Legal business name | Gordon, Mary Burkhart |
| Credentials | ARNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 13th, 2006 |
| Last updated | Feb 13th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821169590 | NPPES |
| Other | 6544 | PHS PROVIDER NUMBER | |
| Other | P01137754 | PHS PROVIDER NUMBER | |
| MEDICAID | 002828500 | PHS PROVIDER NUMBER | |
| Other | 10001631801 | PHS PROVIDER NUMBER | |
| MEDICAID | 427250709 | PHS PROVIDER NUMBER | |
| Other | 500028442 | PHS PROVIDER NUMBER | |
| Other | 511800 | PHS PROVIDER NUMBER | |
| Other | 481202402 | PHS PROVIDER NUMBER | |
| MEDICAID | 757385 | PHS PROVIDER NUMBER | |
| MEDICAID | 100446630A | PHS PROVIDER NUMBER |
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