Corlista Anne Burgess, CNM, PHMNP-BC
Nurse Practitioner, Psych/Mental Health in Hampton, VA. Individual provider (NPI-1).
NPI number1982945069
StatusActive
Last updated in NPPESNov 27, 2023
Details
- NPI
- 1982945069
- Entity type
- Individual (NPI-1)
- Name
- Corlista Anne Burgess
- Credential
- CNM, PHMNP-BC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 14, 2013
- Certification date
- Nov 27, 2023
- Last updated
- Nov 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 0024170057 | VA | Yes |
| 176B00000X | Midwife | 0024170057 | VA |
Other names
- Corlista Anne Damon (Former Name)
Practice location
2604 E Pembroke AveHampton, VA 23664-1248
Phone 757-810-2663
Mailing address
2604 E Pembroke AveHampton, VA 23664-1248
Phone 757-810-2663
Other practice locations
716 Denbigh Blvd Ste E2
Newport News, VA 23608-4414
Newport News, VA 23608-4414
Phone 757-874-2790
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