Healthcare Provider Details

I. General information

NPI: 1538005509
Provider Name (Legal Business Name): GLORIA HARVEY BURTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CAMEROONS PL
DURHAM NC
27703-3915
US

IV. Provider business mailing address

5 CAMEROONS PL
DURHAM NC
27703-3915
US

V. Phone/Fax

Practice location:
  • Phone: 919-880-6875
  • Fax:
Mailing address:
  • Phone: 919-880-6875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number2026-16111-01
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: