Provider Demographics
NPI:1083499669
Name:BURTON, TAWNYA (RN, ALNC)
Entity Type:Individual
Prefix:
First Name:TAWNYA
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:RN, ALNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 847
Mailing Address - Street 2:
Mailing Address - City:PORTALES
Mailing Address - State:NM
Mailing Address - Zip Code:88130-0847
Mailing Address - Country:US
Mailing Address - Phone:575-562-4455
Mailing Address - Fax:
Practice Address - Street 1:103 NORTH CHURCH
Practice Address - Street 2:
Practice Address - City:ELIDA
Practice Address - State:NM
Practice Address - Zip Code:88116
Practice Address - Country:US
Practice Address - Phone:575-274-6211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR39569163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool