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KALEB ANDREW BURGESS CRNA

>> Nurse Anesthetist, Certified Registered >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1770107583

Individual Registrant:
 KALEB ANDREW BURGESS CRNA
Gender: M
Not Sole Proprietor

Location and contact information for practice:
4401 RIVERCHASE DR  PHENIX CITY, AL 36867-7483 US
Tel: 334-732-3000  Fax: --

Contact information for business:
6225 N STATE HIGHWAY 161 STE 200  IRVING, TX 75038-2241 US
Tel: --  Fax: --

Registration Information:
NPI: 1770107583
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y367500000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Anesthetist, Certified Registered
AL1-149764

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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