MEDICARE: GERRIANN BURTON NP

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	363LF0000X	Family Nurse Practitioner	5016701	NC

General Provider Information

NPI Number	:	1265166938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERRIANN BURTON NP

Provider Business Mailing Address
First Line	:	211 PARNELL RD
Second Line	:
City	:	HUBERT
State	:	NC
Zip	:	28539-4523
Country	:	US
Telephone Number	:	830-203-8745
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 OFFICE PARK DR
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-7326
Country	:	US
Telephone Number	:	910-353-9906
Fax Number	:

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

Provider Enumeration Date	:	07/10/2022
Last Update Date	:	12/15/2024

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