Provider Demographics
NPI:1891746699
Name:BURGESS, MARSHA KAY (CRNP)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:KAY
Last Name:BURGESS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 COLUMBIANA ROAD
Mailing Address - Street 2:SUITE 4000
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-2158
Mailing Address - Country:US
Mailing Address - Phone:205-552-1727
Mailing Address - Fax:205-536-8404
Practice Address - Street 1:2090 CULUMBIANA ROAD
Practice Address - Street 2:SUTIE 4000
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-2158
Practice Address - Country:US
Practice Address - Phone:205-552-1727
Practice Address - Fax:205-536-8404
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-063536363L00000X
OR201502950NP-PP363L00000X
GARN235096363L00000X
OHCOA.17214-NP363L00000X
IAH136507363L00000X
FLARNP9380741363L00000X
VA024171680363L00000X
TXAP126579363L00000X
NVAPRN001804363L00000X
NMCNP-02516363L00000X
CANP95001660363L00000X
MACNPRN229764363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner