Healthcare Provider Details
I. General information
NPI: 1326576653
Provider Name (Legal Business Name): ANGELA BETH BURGESS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/31/2017
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4727 E UNION HILLS DR STE 300
PHOENIX AZ
85050-3387
US
IV. Provider business mailing address
6218 E JUSTINE RD
SCOTTSDALE AZ
85254-1946
US
V. Phone/Fax
- Phone: 602-293-3382
- Fax:
- Phone: 480-363-1438
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | RN155985 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | CRNA1435 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: