MEDICARE: AMY BURGESS APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	0993099	CO

General Provider Information

NPI Number	:	1417370677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY BURGESS APN

Provider Business Mailing Address
First Line	:	15949 DAWSON CREEK DR
Second Line	:
City	:	MONUMENT
State	:	CO
Zip	:	80132-6082
Country	:	US
Telephone Number	:	719-210-7571
Fax Number	:

Provider Business Practice Location Address
First Line	:	15949 DAWSON CREEK DR
Second Line	:
City	:	MONUMENT
State	:	CO
Zip	:	80132-6082
Country	:	US
Telephone Number	:	719-210-7571
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2014
Last Update Date	:	01/06/2026

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Directions to “ AMY BURGESS APN” Practice Location

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