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Individual

MRS. KIMBERLY EDWARDS BURGIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
2946 CAPPER RD, JACKSONVILLE, FL 32218-5140
(904) 864-6672
Mailing address
2946 CAPPER RD, JACKSONVILLE, FL 32218-5140
(904) 864-6672

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 5170473
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6935214 96
FL
Enumeration date
05/21/2008
Last updated
05/21/2008
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