Individual
KRISTA NICOLE BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 274-4779
(317) 948-9806
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 777-6435
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
28225152A
IN
363LN0000X
Neonatal Nurse Practitioner
Primary
71013049A
IN
363LP0200X
Pediatric Nurse Practitioner
71013049A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300069057
—
IN
Enumeration date
09/12/2022
Last updated
01/05/2023
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