Healthcare Provider Details
I. General information
NPI: 1487632063
Provider Name (Legal Business Name): KAREN SUE BURGOON CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/04/2006
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9104 BABCOCK BLVD SUITE 2120
PITTSBURGH PA
15237-5818
US
IV. Provider business mailing address
155 MEMORIAL DR
PINEHURST NC
28374-8710
US
V. Phone/Fax
- Phone: 412-367-0600
- Fax: 412-367-7079
- Phone: 412-860-9781
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 5000686 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 0050-00686 |
| License Number State | NC |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | SP007580 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: