MEDICARE: MARSHA KAY BURGESS CRNP

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	363L00000X	Nurse Practitioner	1-063536	AL
2	363L00000X	Nurse Practitioner	201502950NP-PP	OR
3	363L00000X	Nurse Practitioner	RN235096	GA
4	363L00000X	Nurse Practitioner	COA.17214-NP	OH
5	363L00000X	Nurse Practitioner	H136507	IA
6	363L00000X	Nurse Practitioner	ARNP9380741	FL
7	363L00000X	Nurse Practitioner	024171680	VA
8	363L00000X	Nurse Practitioner	AP126579	TX
9	363L00000X	Nurse Practitioner	APRN001804	NV
10	363L00000X	Nurse Practitioner	CNP-02516	NM
11	363L00000X	Nurse Practitioner	NP95001660	CA
12	363L00000X	Nurse Practitioner	CNPRN229764	MA

General Provider Information

NPI Number	:	1891746699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARSHA KAY BURGESS CRNP

Provider Business Mailing Address
First Line	:	2090 COLUMBIANA ROAD
Second Line	:	SUITE 4000
City	:	BIRMINGHAM
State	:	AL
Zip	:	35216-2158
Country	:	US
Telephone Number	:	205-552-1727
Fax Number	:	205-536-8404

Provider Business Practice Location Address
First Line	:	2090 CULUMBIANA ROAD
Second Line	:	SUTIE 4000
City	:	BIRMINGHAM
State	:	AL
Zip	:	35216-2158
Country	:	US
Telephone Number	:	205-552-1727
Fax Number	:	205-536-8404

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	09/15/2015

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