Basic Information
| Provider Information | |||||||||
| NPI: | 1184630865 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BURTON | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 N ACRES RD STE 30 | ||||||||
| Address2: | |||||||||
| City: | PRESCOTT | ||||||||
| State: | WI | ||||||||
| PostalCode: | 540217039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7152624441 | ||||||||
| FaxNumber: | 7152624443 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 N ACRES RD STE 30 | ||||||||
| Address2: | |||||||||
| City: | PRESCOTT | ||||||||
| State: | WI | ||||||||
| PostalCode: | 540217039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7152624441 | ||||||||
| FaxNumber: | 7152624443 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LG0600X | R105181-2 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
No ID Information.