Provider Demographics
NPI:1851984140
Name:BURTON, MILLIE ANITA
Entity Type:Individual
Prefix:
First Name:MILLIE
Middle Name:ANITA
Last Name:BURTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4126 MIGRATION LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-7828
Mailing Address - Country:US
Mailing Address - Phone:614-809-9011
Mailing Address - Fax:
Practice Address - Street 1:4126 MIGRATION LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-7828
Practice Address - Country:US
Practice Address - Phone:614-809-9011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider