Healthcare Provider Details

I. General information

NPI: 1932023801
Provider Name (Legal Business Name): GRACE BURGIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 NEWMAN RD
NEW BERN NC
28562-5238
US

IV. Provider business mailing address

702 NEWMAN RD
NEW BERN NC
28562-5238
US

V. Phone/Fax

Practice location:
  • Phone: 252-633-5333
  • Fax:
Mailing address:
  • Phone: 252-633-5333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-16863
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: