Provider Demographics
NPI:1730403379
Name:BURKHOLDER, CHARLENE ANTONELLI (CRNP)
Entity type:Individual
Prefix:MRS
First Name:CHARLENE
Middle Name:ANTONELLI
Last Name:BURKHOLDER
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:2701 DEKALB PIKE
Mailing Address - Street 2:
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19401-1820
Mailing Address - Country:US
Mailing Address - Phone:610-292-7130
Mailing Address - Fax:610-278-2072
Practice Address - Street 1:2701 DEKALB PIKE
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19401-1820
Practice Address - Country:US
Practice Address - Phone:610-292-7130
Practice Address - Fax:610-278-2072
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP009826363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily