Provider Demographics
NPI:1437324183
Name:BURGIN, TREVA M (RNFA)
Entity Type:Individual
Prefix:
First Name:TREVA
Middle Name:M
Last Name:BURGIN
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:TREVA
Other - Middle Name:M
Other - Last Name:RANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1220 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3704
Mailing Address - Country:US
Mailing Address - Phone:812-282-8494
Mailing Address - Fax:812-280-3030
Practice Address - Street 1:1850 STATE ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4990
Practice Address - Country:US
Practice Address - Phone:812-949-7417
Practice Address - Fax:812-949-7142
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28140890A163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant