Healthcare Provider Details

I. General information

NPI: 1023694437
Provider Name (Legal Business Name): TONECESA BURTTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 PROVIDENCE PKWY
COVINGTON GA
30014-8353
US

IV. Provider business mailing address

85 PROVIDENCE PKWY
COVINGTON GA
30014-8353
US

V. Phone/Fax

Practice location:
  • Phone: 770-462-9202
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN-NP247259
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN-NP247259
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: