Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 5008613 | NC |
NPI | 1003265943 |
---|---|
Provider Name | Mrs. Anna Philbeck Burgess |
First Address | Mooresboro, NC 28114-6713 |
Second Address | Mooresboro, NC 28114-6713 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2016 |
Last Update Date | 03/12/2020 |