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Individual
CORLISTA ANNE BURGESS
Active
Individual
CORLISTA ANNE BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, PHMNP-BC
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
0024170057
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024170057
VA
Other
Enumeration date
03/14/2013
Last updated
11/27/2023
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