Provider Demographics
NPI:1366284101
Name:BURGE, WAUNA LEWIS (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:WAUNA
Middle Name:LEWIS
Last Name:BURGE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 LIME CREEK BND
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:AL
Mailing Address - Zip Code:35043-5593
Mailing Address - Country:US
Mailing Address - Phone:205-218-5679
Mailing Address - Fax:
Practice Address - Street 1:412 LIME CREEK BND
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:AL
Practice Address - Zip Code:35043-5593
Practice Address - Country:US
Practice Address - Phone:205-218-5679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-081992363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily