Individual
ASHLEY LAUREN BURLESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2880 TRICOM ST, NORTH CHARLESTON, SC 29406-9171
(843) 797-5050
(843) 797-3633
Mailing address
2880 TRICOM ST, NORTH CHARLESTON, SC 29406-9171
(843) 797-5050
(843) 797-3633
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3593
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225006760
GROUP NPI NO.
SC
01
—
1326287434
MEDICAID DME NPI
SC
01
—
1701
GROUP MEDICARE
SC
01
—
20076508
SELECT HEALTH DME
SC
01
—
20083697
SELECT HEALTH FIRST CHOICE
SC
01
—
56162
MEDCOST
SC
01
—
57-0634057
GROUP TAX ID #
SC
05
—
NP1368
—
SC
Enumeration date
10/09/2008
Last updated
08/31/2009
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