Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kellan Matthew Burdine

Individual provider Licensed Practical Nurse · NPI 1407458110

Kellan Matthew Burdine is a Licensed Practical Nurse in Tacoma, Washington. Licensed in Texas. Registered with an NPI since 2020.

Licensed in
TX
In the registry since
2020

Practice location Address checks out

9040 Jackson Ave Attn: Mchj-Clq-C
Tacoma, WA 98431-1100
Phone: (520) 275-3851
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 348966 (TX)

Record details

NPI number1407458110
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 9, 2020
Last updated in NPPESNovember 9, 2020
Certification dateNovember 9, 2020
Mailing address9040 Jackson Ave, Attn: McHj-Clq-C, Tacoma, WA 98431-1100

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