Healthcare Provider Details

I. General information

NPI: 1861336984
Provider Name (Legal Business Name): JULIE BURTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E VETERANS ST
TOMAH WI
54660-3105
US

IV. Provider business mailing address

20427 ARCADIA AVE
WARRENS WI
54666-8578
US

V. Phone/Fax

Practice location:
  • Phone: 608-374-8182
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number136461-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: