Individual
MRS. GWENDOLYN DENISE BURNSIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
11841 ROAD 832, PHILADELPHIA, MS 39350-6837
(601) 416-4488
Mailing address
11841 ROAD 832, PHILADELPHIA, MS 39350-6837
(601) 416-4488
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906156
MS
Other
Enumeration date
07/31/2023
Last updated
04/08/2025
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