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General NPI Number Information
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NPI Number | 1891261863
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Entity Type | Individual
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Provider Name | MEAGAN ANN BURGESS APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/17/2018
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Last Update Date | 03/02/2023
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Provider Practice Location Address
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Address Line | 3208 W LAKE MARY BLVD STE 1710
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City | LAKE MARY
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State | FL
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Zip | 32746-3467
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Country | US
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Telephone | 407-732-4627
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Fax | 641-244-3515
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Provider Business Mailing Address
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Address Line | 151 ANCONA AVE
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City | DEBARY
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State | FL
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Zip | 32713-5403
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Country | US
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Telephone | 407-361-5785
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9366520
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License Number State | FL
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