Individual
NANCY MARIE BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANPC
Contact information
Practice address
3617 S PACIFIC HWY, MEDFORD, OR 97501-8957
(541) 535-6239
(541) 512-1026
Mailing address
3617 S PACIFIC HWY, MEDFORD, OR 97501-8957
(541) 535-6239
(541) 512-1026
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
649948
TX
363LF0000X
Family Nurse Practitioner
Primary
200750134NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200750134NP
OREGON STATE LICENSE
OR
01
—
649948
REGISTERED NURSE LICENSE
TX
Enumeration date
12/01/2006
Last updated
07/21/2022
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