Healthcare Provider Details

I. General information

NPI: 1609443860
Provider Name (Legal Business Name): BURTON ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2021
Last Update Date: 06/07/2021
Certification Date: 06/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3620 JOSEPH SIEWICK DR
FAIRFAX VA
22033-1756
US

IV. Provider business mailing address

12423 ERICA HILL LN
FAIRFAX VA
22033-4287
US

V. Phone/Fax

Practice location:
  • Phone: 703-264-7801
  • Fax:
Mailing address:
  • Phone: 480-338-2724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: CAROLINE SEXSON
Title or Position: OWNER
Credential: CRNA
Phone: 480-338-2724