DOMINIQUE BURGESS GIBSONVILLE, NC

Contact Information

DOMINIQUE BURGESS

203 JOE GIBSON DR
GIBSONVILLE, NC 27249-9811

Phone: 919-508-4483
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Non-emergency Medical Transport (VAN)	343900000X
Case Management	251B00000X
Community/Behavioral Health	251S00000X
Doula	374J00000X
Early Intervention Provider Agency	252Y00000X
Mental Health (Including Community Mental Health Center)	261QM0801X	B4[14]	Community Mental Health Center

Indicates primary specialty

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NPI Profile & details for DOMINIQUE BURGESS · (Female)

NPI Number	`1619545191`
Status	Active
Credentials
Entity	Individual
Enumeration date	06/11/2021
Last updated	04/27/2026 - About 1 months ago
Sole proprietor ¹	No
Identifiers	Not Available
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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