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Individual

MRS. KRISTEN LEBEAU BURGESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
3620 COURT DR, BLDG K, ZANESVILLE, OH 43701-6456
(740) 454-1248
(740) 454-8183
Mailing address
PO BOX 1821, ZANESVILLE, OH 43702-1821
(740) 455-3304
(740) 455-3686

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
318939
OH
363L00000X
Nurse Practitioner
Primary
318939
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2136709
OH
Enumeration date
09/24/2007
Last updated
06/09/2011
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