Healthcare Provider Details

I. General information

NPI: 1962017111
Provider Name (Legal Business Name): ANNA BUETON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2020
Last Update Date: 09/14/2020
Certification Date: 09/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN RD
DURHAM NC
27705-4699
US

IV. Provider business mailing address

1108 DEXTER RIDGE DR
HOLLY SPRINGS NC
27540-7663
US

V. Phone/Fax

Practice location:
  • Phone: 919-681-5961
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number5013546
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: