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Organization

INTEGRATED PSYCHOGENIC WELLNESS ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EVANNA BURKETT RN, FNP-C, DNP (NURSE PRACTITIONER)
(336) 736-1452
Entity
Organization

Contact information

Practice address
1205 W BESSEMER AVE # 1213, GREENSBORO, NC 27408-8442
(336) 736-1452
Mailing address
2672 SPLITBROOK DR, HIGH POINT, NC 27265-7980

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
210912
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1255504742
NC
Enumeration date
05/15/2018
Last updated
05/15/2018
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