Provider Demographics
NPI:1275274185
Name:BURGAMY, TONYA ANN (RN, FNP-C)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:ANN
Last Name:BURGAMY
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:ANN
Other - Last Name:HUBBARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2465
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:GA
Mailing Address - Zip Code:31032-2465
Mailing Address - Country:US
Mailing Address - Phone:478-955-6397
Mailing Address - Fax:
Practice Address - Street 1:6501 PEAKE RD STE 400
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-8046
Practice Address - Country:US
Practice Address - Phone:478-477-0966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN170259363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily