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Organization
BURGESS PRIMARY FAMILY PRACTICE LLC
Active
Organization
BURGESS PRIMARY FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY BURGESS NP (OWNER)
(843) 319-6089
Entity
Organization
Contact information
Practice address
1211 N MAIN ST, MARION, SC 29571-2008
(843) 319-6089
Mailing address
PO BOX 1143, MARION, SC 29571-1143
(843) 319-6089
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
363L00000X
Nurse Practitioner
Primary
—
—
363LC1500X
Community Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
363LX0106X
Occupational Health Nurse Practitioner
—
—
Other
Enumeration date
06/14/2023
Last updated
01/03/2024
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