Basic Information
Provider Information
NPI: 1508122300
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BURK
FirstName: REBECCA
MiddleName: EMILY
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1155 MILL ST MS M14
Address2:  
City: RENO
State: NV
PostalCode: 895021576
CountryCode: US
TelephoneNumber: 7759825262
FaxNumber: 7759824196
Practice Location
Address1: 1155 MILL ST
Address2:  
City: RENO
State: NV
PostalCode: 895021576
CountryCode: US
TelephoneNumber: 7759827878
FaxNumber: 7759824196
Other Information
ProviderEnumerationDate: 04/05/2012
LastUpdateDate: 06/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X18894NVN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RP1001X18894NVN Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RC0200X18894NVY Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine

No ID Information.


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