Individual
BRIDGET BURNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1220 JEFFERSON ST, LAUREL, MS 39440-4355
(601) 426-4036
Mailing address
34 OLETA DR, ELLISVILLE, MS 39437-7219
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
904626
MS
Other
Enumeration date
05/20/2021
Last updated
05/20/2021
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