Provider Demographics
NPI:1215414362
Name:BURTON, JADAWNYA (CNA)
Entity Type:Individual
Prefix:
First Name:JADAWNYA
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 CHERI PL
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30238-4580
Mailing Address - Country:US
Mailing Address - Phone:770-837-5425
Mailing Address - Fax:
Practice Address - Street 1:284 CHERI PL
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30238-4580
Practice Address - Country:US
Practice Address - Phone:770-837-5425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-22
Last Update Date:2018-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0028890695376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1669981536OtherNPPES