Provider Demographics
NPI:1104012897
Name:BURGESS, EMILY C (DC, RN)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:C
Last Name:BURGESS
Suffix:
Gender:F
Credentials:DC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5667 CANE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-3903
Mailing Address - Country:US
Mailing Address - Phone:615-479-0788
Mailing Address - Fax:
Practice Address - Street 1:3718 NOLENSVILLE RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-3302
Practice Address - Country:US
Practice Address - Phone:615-880-2138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-17
Last Update Date:2022-05-13
Deactivation Date:2022-04-06
Deactivation Code:
Reactivation Date:2022-05-09
Provider Licenses
StateLicense IDTaxonomies
TNRN0000149773163WS0200X
TN2728111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No163WS0200XNursing Service ProvidersRegistered NurseSchool