Individual
MRS. OLIVIA CARSYN BURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1529 SIMPSON HIGHWAY 49 STE A, MAGEE, MS 39111-4209
(601) 439-7288
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 849-1530
(601) 849-1535
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
903579
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07839287
—
MS
01
—
1P5842
MEDICARE ST DOM
MS
01
—
903579
MS STATE LICENSE
MS
Enumeration date
10/23/2019
Last updated
06/10/2021
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