Basic Information
| Provider Information | |||||||||
| NPI: | 1831142017 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BURTON | ||||||||
| FirstName: | PRISCILLA | ||||||||
| MiddleName: | STERINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1886 CAMERON HILL RD | ||||||||
| Address2: | |||||||||
| City: | CAMERON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283268096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9194983598 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2300 RAMSEY ST | ||||||||
| Address2: | DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER | ||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104882120 | ||||||||
| FaxNumber: | 9104825099 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | C003033 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.