Healthcare Provider Details

I. General information

NPI: 1891746699
Provider Name (Legal Business Name): MARSHA KAY BURGESS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 09/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2090 CULUMBIANA ROAD SUTIE 4000
BIRMINGHAM AL
35216-2158
US

IV. Provider business mailing address

2090 COLUMBIANA ROAD SUITE 4000
BIRMINGHAM AL
35216-2158
US

V. Phone/Fax

Practice location:
  • Phone: 205-552-1727
  • Fax: 205-536-8404
Mailing address:
  • Phone: 205-552-1727
  • Fax: 205-536-8404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-063536
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number201502950NP-PP
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN235096
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCOA.17214-NP
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberH136507
License Number StateIA
# 6
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9380741
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number024171680
License Number StateVA
# 8
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP126579
License Number StateTX
# 9
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN001804
License Number StateNV
# 10
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP-02516
License Number StateNM
# 11
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP95001660
License Number StateCA
# 12
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNPRN229764
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: