MEDICARE: KAREN A. BURTON N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	R105181-2	MN

General Provider Information

NPI Number	:	1184630865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN A. BURTON N.P.

Provider Business Mailing Address
First Line	:	1400 N ACRES RD STE 30
Second Line	:
City	:	PRESCOTT
State	:	WI
Zip	:	54021-7039
Country	:	US
Telephone Number	:	715-262-4441
Fax Number	:	715-262-4443

Provider Business Practice Location Address
First Line	:	1400 N ACRES RD STE 30
Second Line	:
City	:	PRESCOTT
State	:	WI
Zip	:	54021-7039
Country	:	US
Telephone Number	:	715-262-4441
Fax Number	:	715-262-4443

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/08/2007

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