Individual
CAROL ANN BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
167 NORTH MAIN ST, TUBA CITY, AZ 86045
(928) 283-2501
Mailing address
PO BOX 1230, TUBA CITY, AZ 86045-1230
(928) 225-5732
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
134234-030
WI
Other
Enumeration date
10/14/2010
Last updated
10/14/2010
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