Healthcare Provider Details

I. General information

NPI: 1184630865
Provider Name (Legal Business Name): KAREN A. BURTON N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N ACRES RD STE 30
PRESCOTT WI
54021-7039
US

IV. Provider business mailing address

1400 N ACRES RD STE 30
PRESCOTT WI
54021-7039
US

V. Phone/Fax

Practice location:
  • Phone: 715-262-4441
  • Fax: 715-262-4443
Mailing address:
  • Phone: 715-262-4441
  • Fax: 715-262-4443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberR105181-2
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: