Provider Demographics
NPI:1164857488
Name:BURGESS, MARIA L (APRN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:L
Last Name:BURGESS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:L
Other - Last Name:PALCHETTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5875 S RAINBOW BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-2556
Mailing Address - Country:US
Mailing Address - Phone:702-465-7471
Mailing Address - Fax:949-404-6317
Practice Address - Street 1:5875 S RAINBOW BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-2556
Practice Address - Country:US
Practice Address - Phone:702-465-7471
Practice Address - Fax:949-404-6317
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN001574363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily