Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | MD.206887 | LA |
NPI | 1053554782 |
---|---|
Provider Name | Dr. Victoria Elizabeth Burke |
First Address | Metairie, LA 70005-1037 |
Second Address | New Orleans, LA 70112-2865 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2009 |
Last Update Date | 05/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07088338 | MEDICAID (01) | MS |
2371410 | (05) | LA |