Basic Information
Provider Information
NPI: 1356327860
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BURR
FirstName: KAREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4131 W LOOMIS RD
Address2: SUITE 300
City: GREENFIELD
State: WI
PostalCode: 532212057
CountryCode: US
TelephoneNumber: 4143257246
FaxNumber: 4143253770
Practice Location
Address1: 4131 W LOOMIS RD
Address2: SUITE 300
City: GREENFIELD
State: WI
PostalCode: 532212057
CountryCode: US
TelephoneNumber: 4143257246
FaxNumber: 4143253770
Other Information
ProviderEnumerationDate: 12/16/2005
LastUpdateDate: 12/15/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X133078WIY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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