MEDICARE: LATONYA E BURTON APRN

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	20478	SC

General Provider Information

NPI Number	:	1356882278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATONYA E BURTON APRN

Provider Business Mailing Address
First Line	:	4741 HIGHWAY 153 STE B
Second Line	:
City	:	EASLEY
State	:	SC
Zip	:	29642-9214
Country	:	US
Telephone Number	:	888-506-5558
Fax Number	:	864-900-4676

Provider Business Practice Location Address
First Line	:	4741 HIGHWAY 153 STE B
Second Line	:
City	:	EASLEY
State	:	SC
Zip	:	29642-9214
Country	:	US
Telephone Number	:	888-506-5558
Fax Number	:	864-900-4676

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

Provider Enumeration Date	:	03/10/2017
Last Update Date	:	12/01/2025

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