Provider Demographics
NPI:1124767983
Name:BURTON, PATRICIA DAWN (BSN, RN, CCM)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:DAWN
Last Name:BURTON
Suffix:
Gender:F
Credentials:BSN, RN, CCM
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:SAPP
Other - Last Name:BURTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BSN, RN, CCM
Mailing Address - Street 1:4625 SHATTALON CIR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-1821
Mailing Address - Country:US
Mailing Address - Phone:336-407-8838
Mailing Address - Fax:877-211-6810
Practice Address - Street 1:4625 SHATTALON CIR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-1821
Practice Address - Country:US
Practice Address - Phone:336-999-3330
Practice Address - Fax:877-211-6810
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC096571163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management