Individual
MRS. ANNIE SUSAN JOANN BURGOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-BC
Contact information
Practice address
204 KEN DR, KILLEEN, TX 76542-2106
(573) 424-3137
Mailing address
204 KEN DR, KILLEEN, TX 76542-2106
(573) 424-3137
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
965101
TX
363LF0000X
Family Nurse Practitioner
Primary
AP141417
TX
Other
Enumeration date
07/19/2018
Last updated
08/05/2020
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