Provider Demographics
NPI:1184630865
Name:BURTON, KAREN A (NP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:BURTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 N ACRES RD STE 30
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:WI
Mailing Address - Zip Code:54021-7039
Mailing Address - Country:US
Mailing Address - Phone:715-262-4441
Mailing Address - Fax:715-262-4443
Practice Address - Street 1:1400 N ACRES RD STE 30
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:WI
Practice Address - Zip Code:54021-7039
Practice Address - Country:US
Practice Address - Phone:715-262-4441
Practice Address - Fax:715-262-4443
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR105181-2363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNP38812Medicare UPIN
WI43969800Medicare ID - Type Unspecified