Individual
MS. VICTORIA H BURSLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1279 HWY 54 WEST, SUITE 220, FAYETTEVILLE, GA 30214-4552
(770) 991-2200
(770) 991-1341
Mailing address
1279 HWY 54 WEST, SUITE 220, FAYETTEVILLE, GA 30214-4552
(770) 991-2200
(770) 991-1341
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
RN127607
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000288
LICENSED NURSE MIDWIFE
CT
05
—
000696484E
—
GA
01
—
077450
REGISTERED NURSE
CT
Enumeration date
07/15/2006
Last updated
10/27/2011
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