Provider Demographics
NPI:1891261863
Name:BURGESS, MEAGAN ANN (APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MEAGAN
Middle Name:ANN
Last Name:BURGESS
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:ANN
Other - Last Name:WINCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:151 ANCONA AVE
Mailing Address - Street 2:
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-5403
Mailing Address - Country:US
Mailing Address - Phone:407-361-5785
Mailing Address - Fax:
Practice Address - Street 1:3208 W LAKE MARY BLVD STE 1710
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3467
Practice Address - Country:US
Practice Address - Phone:407-732-4627
Practice Address - Fax:641-244-3515
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9366520363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily