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NPI 1558026419

NPI 1558026419 : HANNAH L BURTON : NEENAH, WI

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General NPI Number Information
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    NPI Number           |    1558026419
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    Entity Type          |    Individual 
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    Provider Name        |    HANNAH L BURTON
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/05/2021
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    Last Update Date     |    10/08/2024
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Provider Practice Location Address
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    Address Line         |    333 N GREEN BAY RD 
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    City                 |    NEENAH
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    State                |    WI
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    Zip                  |    54956-1954
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    Country              |    US
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    Telephone            |    920-725-2070
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    Fax                  |    920-725-4549
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Provider Business Mailing Address
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    Address Line         |    3 NEENAH CTR 
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    City                 |    NEENAH
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    State                |    WI
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    Zip                  |    54956-3070
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    Country              |    US
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    Telephone            |    920-830-5900
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    Fax                  |    920-830-5910
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    5848
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    License Number State |    WI
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