Individual
DONNETTA BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
509 W UNIVERSITY AVE, URBANA, IL 61801-1645
(217) 383-6636
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209021365
IL
Other
Enumeration date
10/08/2020
Last updated
04/18/2024
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