Provider Demographics
NPI:1962148569
Name:BURGESS, ANDREA ROSALIA (PA-C)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:ROSALIA
Last Name:BURGESS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10207 CERNY ST STE 312
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-4887
Mailing Address - Country:US
Mailing Address - Phone:919-660-8346
Mailing Address - Fax:
Practice Address - Street 1:10207 CERNY ST # 312B
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-4879
Practice Address - Country:US
Practice Address - Phone:919-660-8346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-07
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant