Provider Demographics
NPI:1497015184
Name:BURTON, COURTNEY ASHLEY (FNP)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:ASHLEY
Last Name:BURTON
Suffix:
Gender:F
Credentials:FNP
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 638
Mailing Address - Street 2:
Mailing Address - City:DUE WEST
Mailing Address - State:SC
Mailing Address - Zip Code:29639-0638
Mailing Address - Country:US
Mailing Address - Phone:864-379-2345
Mailing Address - Fax:
Practice Address - Street 1:6 COLLEGE STREET
Practice Address - Street 2:
Practice Address - City:DUE WEST
Practice Address - State:SC
Practice Address - Zip Code:29639
Practice Address - Country:US
Practice Address - Phone:864-379-2345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17814363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily