Provider Demographics
NPI:1831757780
Name:BURTON, TONI LYNN
Entity type:Individual
Prefix:MRS
First Name:TONI
Middle Name:LYNN
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 1:3573 BELLROSE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-9142
Mailing Address - Country:US
Mailing Address - Phone:517-867-2625
Mailing Address - Fax:
Practice Address - Street 1:133 GAUNT AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-5712
Practice Address - Country:US
Practice Address - Phone:517-867-2625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIB635799564983372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider