PROF. CONSTANCE ANGELA BURKE (NPI# 1194076042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194076042 |
| Entity Type | Individual |
| Full Name | PROF. CONSTANCE ANGELA BURKE |
| Credential | PA-C |
| Practice Address |
4001 W Mcnichols Rd Detroit MI 48221-3038 |
| Mailing Address |
6553 Island Lake Dr Brighton MI 48116-9571 |
| Practice Telephone | 3139931773 |
| Mailing Telephone | 5868556783 |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2017-03-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601002877 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4001 W MCNICHOLS RD |
| City | DETROIT |
| State | MI |
| Zip Code | 48221-3038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558349050 | Amy Dereczyk | Physician Assistant | 4001 W Mcnichols Rd, Detroit, MI 48221-3038 | 2006-01-04 |
| 1073131371 | Hannah Kathleen West | Specialist/Technologist | 4001 W Mcnichols Rd, Detroit, MI 48221-3038 | 2020-07-13 |
| 1326667833 | Kirsten Lynn Larson | Specialist/Technologist | 4001 W Mcnichols Rd, Detroit, MI 48221-3038 | 2020-04-14 |
| 1922635093 | Brianne Jacobson | Specialist/Technologist | 4001 W Mcnichols Rd, Detroit, MI 48221-3038 | 2020-03-26 |
| 1679107585 | Mitzi Saunders | Clinical Nurse Specialist | 4001 W Mcnichols Rd, Detroit, MI 48221-3038 | 2020-02-29 |
| 1679040133 | Abigail Lillian Barno | Specialist/Technologist | 4001 W Mcnichols Rd, Detroit, MI 48221-3038 | 2018-11-01 |
| 1265841662 | Lainie Bisbee | Specialist/Technologist | 4001 W Mcnichols Rd, Calihan Hall, Detroit, MI 48221-3038 | 2014-08-11 |
| 1457769341 | Michael Miller | Specialist/Technologist | 4001 W Mcnichols Rd, Detroit, MI 48221-3038 | 2014-07-24 |
| 1518373919 | Ashley Vanmeter | Specialist/Technologist | 4001 W Mcnichols Rd, Detroit, MI 48221-3038 | 2014-07-07 |
| 1245579671 | Julia Stocker Schneider | Registered Nurse | 4001 W Mcnichols Rd, Detroit, MI 48221-3038 | 2013-02-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992359285 | Sutherlond Homes | Home Infusion | 20499 Ilene, Detroit, MI 48221 | 2019-07-25 |
| 1447743216 | Prolific Care Home Health Svc | Home Health | 10141 W. Mcnichols St., Detroit, MI 48221 | 2018-06-07 |
| 1982103297 | Diamond A Lowe | Technician/Technologist | 16654 Monte Vista, Detroit, MI 48221 | 2018-02-02 |
| 1356871941 | Tamika Baines | Driver | 19939 Indiana, Detroit, MI 48221 | 2017-06-15 |
| 1821535667 | Tanisha Floyd | Behavior Technician | 18307 Mendota St., Detroit, MI 48221 | 2017-01-31 |
| 1225585250 | Maan Down LLC | Custodial Care Facility | 16885 Ilene St, Detroit, MI 48221 | 2016-09-07 |
| 1285013979 | Thiera Danyal Lane | Counselor | 11000 W Mcnichols Rd Ste 309, Detroit, MI 48221 | 2015-05-27 |
| 1679967038 | Remy Onimoe | Pharmacist | 16191 Livernois Avenue, Southfield, MI 48221 | 2015-03-24 |
| 1669863098 | Loving Hands Accessible Service L.L.C. | Driver | 16230 Mendota, Detroit, MI 48221 | 2015-02-06 |
| 1487916433 | Social Care Administrators LLC | Case Management | 11000 W. Mcnicholas, Ste 212, Detroit, MI 48221 | 2012-06-14 |
| Find all providers in zip 48221 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831340355 | Antonia L Navarro | Physician Assistant | University Physician Group Oncology, 4100 John R, Detroit, MI 48201-2013 | 2008-10-02 |
| 1104974443 | Amy B Oatfield | Physician Assistant | Henry Ford Hospital Trauma and Critical Care Cfp-1, 2799 West Grand Blvd, Detroit, MI 48202 | 2007-01-05 |
| 1295750677 | Ingrid Dominic Mitchell | Physician Assistant | 18254 Livernois Ave Ste 1, Detroit, MI 48221-4214 | 2006-07-13 |
| 1952397291 | Kelly Michelle Brown | Physician Assistant | 22151 Moross Rd Ste 320, Maternal Fetal Medicine St John Hospital & Medical Cen, Detroit, MI 48236-2196 | 2005-09-22 |
| 1467067975 | Jerrica Clemens | Physician Assistant | 4100 Woodward Ave, Detroit, MI 48201-2173 | 2020-09-11 |
| 1679195176 | Shane Michael Dignan | Physician Assistant | 259 Mack Ave, Detroit, MI 48201-2427 | 2020-05-07 |
| 1174154843 | Weston Alexander Davis | Physician Assistant | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-01-30 |
| 1689225443 | Alaa Eddin Tahboub | Physician Assistant | 4771 Michigan Ave, Detroit, MI 48210-9718 | 2019-09-24 |
| 1609338367 | Aanchal Bhojwani | Physician Assistant | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2019-04-02 |
| 1952883068 | Jeremy Lynn Herzberg | Physician Assistant | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2018-09-05 |
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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.