Healthcare Provider Details

I. General information

NPI: 1396530093
Provider Name (Legal Business Name): CHRISTOPHER BURROUGHS DNP, AGPCNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2025
Last Update Date: 07/03/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5306 NC HIGHWAY 55 STE 105
DURHAM NC
27713-7812
US

IV. Provider business mailing address

5306 NC HIGHWAY 55 STE 105
DURHAM NC
27713-7812
US

V. Phone/Fax

Practice location:
  • Phone: 877-279-5960
  • Fax:
Mailing address:
  • Phone: 877-279-5960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5022561
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: