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General NPI Number Information
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NPI Number | 1891479457
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Entity Type | Individual
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Provider Name | CALEB MICHAEL BURTON FNP-C
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Gender | Male
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Dates
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Enumeration Date | 06/14/2023
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 907 E LAMAR ALEXANDER PKWY
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City | MARYVILLE
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State | TN
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Zip | 37804-5015
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Country | US
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Telephone | 865-977-5565
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Fax | 865-981-2297
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Provider Business Mailing Address
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Address Line | 907 E LAMAR ALEXANDER PKWY
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City | MARYVILLE
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State | TN
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Zip | 37804-5015
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Country | US
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Telephone | 865-977-5565
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Fax | 865-981-2297
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 34106
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License Number State | TN
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