Individual
MARISSA ANN BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1306 W MAIN ST, JEFFERSON CITY, MO 65109-1356
(702) 899-0595
(702) 977-1496
Mailing address
PO BOX 74008272, CHICAGO, IL 60674-8272
(702) 899-0595
(702) 977-1496
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2020001246
MO
Other
Enumeration date
02/11/2020
Last updated
10/07/2025
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