MEDICARE: CAROLINE REBECCA BURROWS PAC

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	363A00000X	Physician Assistant	10450	GA

General Provider Information

NPI Number	:	1427637552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE REBECCA BURROWS PAC

Provider Business Mailing Address
First Line	:	352 W NORTHFIELD BLVD STE 3C
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37129-1899
Country	:	US
Telephone Number	:	770-971-1533
Fax Number	:	770-971-4846

Provider Business Practice Location Address
First Line	:	125 OAKSIDE CT STE 201
Second Line	:
City	:	CANTON
State	:	GA
Zip	:	30114-2498
Country	:	US
Telephone Number	:	844-893-0012
Fax Number	:

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

Provider Enumeration Date	:	04/06/2021
Last Update Date	:	05/22/2025

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