Doctor Name: | DIANE LEE BURTON |
NPI Number: | 1083056493 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 0024171049 |
Business Practice Address: | 8262 Atlee Rd Suite 201 Mechanicsville, VA - 231161816 |
Business Phone Number: | 8043258720 |
Business Fax Number: | 8047647351 |
Mailing Address: | 8262 Atlee Rd, Suite 201 MECHANICSVILLE |
State: | VA |
Postal Code: | 231161816 |
Phone Number: | 8043258720 |
Fax Number: | 8047647351 |
NPI Enumeration Date: | 07/26/2013 |
NPI Last Update Date: | 07/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 0024171049 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |