Individual
AMBER BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1801 GLENDALE DR SW, WILSON, NC 27893-4401
(252) 237-3141
(252) 293-8301
Mailing address
1801 GLENDALE DR SW, WILSON, NC 27893-4401
(252) 237-3141
(252) 293-8301
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
915198
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q40027A
MEDICARE PTAN
NC
Enumeration date
07/12/2012
Last updated
10/18/2012
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