LACY D BURKES (NPI# 1750646279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750646279 |
| Entity Type | Individual |
| Full Name | LACY D BURKES |
| Credential | PNP |
| Practice Address |
205 W Tyler St Canton TX 75103-1352 |
| Mailing Address |
4922 Spring Avenue Dallas TX 75210-1359 |
| Practice Telephone | 9035675437 |
| Practice Fax Number | 8446786258 |
| Mailing Telephone | 4694884700 |
| Mailing Fax Number | 4694884701 |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2020-01-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
754047 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
205 W TYLER ST |
| City | CANTON |
| State | TX |
| Zip Code | 75103-1352 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174087704 | Carlin Brae Hurst | Nurse Practitioner | 205 W Tyler St, Canton, TX 75103-1352 | 2019-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265095202 | Brandi Jo Foster | Nurse Practitioner | 4437 Etheride Circle, Canton, TX 75103 | 2019-04-16 |
| 1124595087 | Melissa Williams | Nurse Practitioner | 1108 So. Buffalo St, Canton, TX 75103 | 2018-10-30 |
| 1295218667 | Jennifer Elaine Moore | Registered Nurse | 185 Vz Cr 2103, Canton, TX 75103 | 2018-09-12 |
| 1568945921 | Kelsey Lauren Nixon | Registered Nurse | 5640 Vzcr 4106, Canton, TX 75103 | 2018-09-12 |
| 1649770496 | Chelsea Boshart | Registered Nurse | 150 Vz Cr 4130, Canton, TX 75103 | 2018-02-19 |
| 1396292918 | Deanne Wheeler | Hearing Instrument Specialist | 150 E. Dallas Street, Canton, TX 75103 | 2016-09-01 |
| 1356701221 | Betsy Jill Chappell | Nurse Practitioner | 406 Tx-243, Canton, TX 75103 | 2016-03-04 |
| 1326435199 | Forever Kids Pediatric Clinic | Clinic/Center | 182 Privatet Road 6413, Canton, TX 75103 | 2015-04-20 |
| 1417255233 | Dallas County Hospital District | Skilled Nursing Facility | 1901 S Trade Days Blvd, Canton, TX 75103 | 2011-03-02 |
| 1922243906 | Brookshire Grocery Company | Pharmacy | 880 E State Highway 243, Canton, TX 75103 | 2008-12-05 |
| Find all providers in zip 75103 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306388715 | Kelly Sarah Spooner | Nurse Practitioner | 1600 S Canton Center Rd Ste 200, Canton, MI 48188 | 2016-11-16 |
| 1750413696 | Patricia Ann Miller | Nurse Practitioner | 4641 Fulton Dr. Nw, Canton, OH 44718 | 2007-03-09 |
| 1780784850 | Kerry Anne Swanton | Nurse Practitioner | 49650 Cherry Hill Rd Ste 210, Canton, MI 48187-4859 | 2006-09-25 |
| 1114494002 | Emily L Koelsch | Nurse Practitioner | 3 Randolph St, Canton, MA 02021-2351 | 2018-10-29 |
| 1487980124 | Julie Slotnick | Nurse Practitioner | 3 Randolph St, Canton, MA 02021-2351 | 2009-11-01 |
| 1881887982 | Karen Wheeler Madden | Nurse Practitioner | 3 Randolph St, Canton, MA 02021-2351 | 2007-08-22 |
| 1043310618 | Patricia Reckling | Nurse Practitioner | 49650 Cherry Hill Rd, Suite 210, Canton, MI 48187-4849 | 2006-09-24 |
| 1013015155 | Wendy Storey | Nurse Practitioner | 49650 Cherry Hill Rd, Suite 210, Canton, MI 48187-4849 | 2006-09-20 |
| 1386742427 | Bryn Gerich Vi | Nurse Practitioner | 49650 Cherry Hill Rd, Suite 210, Canton, MI 48187-4849 | 2006-09-20 |
| 1013015163 | Molly Mcintyre | Nurse Practitioner | 49650 Cherry Hill Rd, Suite 210, Canton, MI 48187-4849 | 2006-09-20 |
| Find all providers in CANTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.