Individual
MRS. MELISSA RENAE BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM
Contact information
Practice address
1506 BLACKSPRUCE CT SW, LILBURN, GA 30047-4440
(678) 602-8087
Mailing address
1506 BLACKSPRUCE CT SW, LILBURN, GA 30047-4440
(678) 602-8087
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
18020007
GA
Other
Enumeration date
03/30/2015
Last updated
11/27/2019
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