Provider Demographics
NPI:1437738473
Name:BURT, JONATHON (RN)
Entity Type:Individual
Prefix:
First Name:JONATHON
Middle Name:
Last Name:BURT
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14591 COUNTY ROAD U
Mailing Address - Street 2:
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545-9747
Mailing Address - Country:US
Mailing Address - Phone:429-308-9533
Mailing Address - Fax:
Practice Address - Street 1:1111 SCOTT ST
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545-1054
Practice Address - Country:US
Practice Address - Phone:419-592-9086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN437480163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse