Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 17808 | NH |
N | 207Q00000X | Family Doctor | MD162070 | OR |
NPI | 1003037904 |
---|---|
Provider Name | Dr. Kristin Oberg Burdick |
First Address | Nashua, NH 03063-1818 |
Second Address | Nashua, NH 03063-1818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 19/10/2016 |