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General NPI Number Information
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NPI Number | 1740394824
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Entity Type | Individual
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Provider Name | ANN MARIE BURGESON BSN, RN. MSN NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 2310 4TH AVE N
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City | MOORHEAD
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State | MN
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Zip | 56560-2473
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Country | US
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Telephone | 218-236-6502
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Fax |
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Provider Business Mailing Address
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Address Line | 2310 4TH AVE N
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City | MOORHEAD
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State | MN
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Zip | 56560-2473
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Country | US
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Telephone | 218-236-6502
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R 168305-7
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R 168305-7
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CNP 0613
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License Number State | MN
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