Provider Demographics
NPI:1225787393
Name:BURRES, MORGANN
Entity Type:Individual
Prefix:
First Name:MORGANN
Middle Name:
Last Name:BURRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14848 N 36TH DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-4614
Mailing Address - Country:US
Mailing Address - Phone:253-888-6962
Mailing Address - Fax:602-610-8721
Practice Address - Street 1:14848 N 36TH DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-4614
Practice Address - Country:US
Practice Address - Phone:253-888-6962
Practice Address - Fax:602-610-8721
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLM252176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife