Provider Demographics
NPI:1558941187
Name:BURGEIS, DAISY (E-RYT)
Entity Type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:BURGEIS
Suffix:
Gender:F
Credentials:E-RYT
Other - Prefix:
Other - First Name:DAISY
Other - Middle Name:
Other - Last Name:WINDHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:105 HICKMAN ST
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-3803
Mailing Address - Country:US
Mailing Address - Phone:615-939-4331
Mailing Address - Fax:
Practice Address - Street 1:2000 GLEN ECHO RD STE 101
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2857
Practice Address - Country:US
Practice Address - Phone:615-457-8585
Practice Address - Fax:615-457-8595
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN