Individual
MRS. GINA MARIE BURBANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
6002 PROFESSIONAL PKWY STE 140, DOUGLASVILLE, GA 30134-5603
(678) 715-9690
(678) 581-7140
Mailing address
531 ROSELANE ST NW STE 710, MARIETTA, GA 30060-6975
(678) 331-3297
(678) 581-7187
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN217757
GA
363LF0000X
Family Nurse Practitioner
Primary
APRN-RN217757
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255808754
NPI NUMBER
GA
Enumeration date
11/01/2018
Last updated
11/20/2025
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