Healthcare Provider Details

I. General information

NPI: 1740459569
Provider Name (Legal Business Name): EMILY CATHERINE BURT AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 06/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 LAKE BOONE TRAIL SUITE 100
RALEIGH NC
27607-7529
US

IV. Provider business mailing address

4600 LAKE BOONE TRAIL SUITE 100
RALEIGH NC
27607-7529
US

V. Phone/Fax

Practice location:
  • Phone: 919-787-1374
  • Fax:
Mailing address:
  • Phone: 919-787-1374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number7865
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: