Doctor Name: | SARAH RICHARDSON BURGESS |
NPI Number: | 1366859613 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 5007009 |
Business Practice Address: | 610 Jetton St Suite 214 Davidson, NC - 280369318 |
Business Phone Number: | 7043841558 |
Business Fax Number: | |
Mailing Address: | Po Box 751803, CHARLOTTE |
State: | NC |
Postal Code: | 282751803 |
Phone Number: | 9806215627 |
Fax Number: | |
NPI Enumeration Date: | 07/18/2014 |
NPI Last Update Date: | 01/13/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 5007009 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |