Burslem, Victoria H

Burslem, Victoria H is an individual health care provider with primary practice located at 1279 Hwy 54 West Suite 220, Fayetteville GA 30214-4552. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Burslem, Victoria H can be contacted via phone (770) 991-2200.

Contact Information

Primary practice address
1279 Hwy 54 West Suite 220 Fayetteville GA 30214-4552
Phone: (770) 991-2200
Fax: (770) 991-1341
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X RN127607 Georgia

Profile Details

NPI number 1407872864
LBN Legal business name Burslem, Victoria H
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2006
Last updated Oct 27th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407872864 NPPES
Georgia MEDICAID 000696484E
Georgia Other 077450
Georgia Other 000288

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