Provider Demographics
NPI:1871629972
Name:BURRIS, WENDY MICHELLE (MPH)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:MICHELLE
Last Name:BURRIS
Suffix:
Gender:F
Credentials:MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:556 WHITE RD
Mailing Address - Street 2:
Mailing Address - City:WARTRACE
Mailing Address - State:TN
Mailing Address - Zip Code:37183-3481
Mailing Address - Country:US
Mailing Address - Phone:931-224-2448
Mailing Address - Fax:
Practice Address - Street 1:556 WHITE RD
Practice Address - Street 2:
Practice Address - City:WARTRACE
Practice Address - State:TN
Practice Address - Zip Code:37183-3481
Practice Address - Country:US
Practice Address - Phone:931-224-2448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider