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Individual
LA'ASHA BURGESS
Active
Individual
LA'ASHA BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2475
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2482PA
—
SC
Enumeration date
11/16/2015
Last updated
02/23/2020
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