Basic Information
| Provider Information | |||||||||
| NPI: | 1740936863 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BURGER | ||||||||
| FirstName: | CELIA | ||||||||
| MiddleName: | VICTORIA | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1105 TOWN BLVD NE UNIT 2517 | ||||||||
| Address2: | |||||||||
| City: | BROOKHAVEN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303193680 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196492986 | ||||||||
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| Practice Location | |||||||||
| Address1: | 275 COLLIER RD NW STE 500 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303091711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4046052800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2022 | ||||||||
| LastUpdateDate: | 06/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 302528 | NC | N | Nursing Service Providers | Registered Nurse | 363L00000X | RN310434 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.