Individual
STEPHANIE E BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1410 BLANDING ST STE 102, COLUMBIA, SC 29201-2967
(803) 256-2500
(803) 758-1726
Mailing address
PO BOX 5731, COLUMBIA, SC 29250-5731
(803) 256-2500
(803) 758-1726
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN481
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FNP001
—
SC
Enumeration date
06/06/2006
Last updated
04/16/2018
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