Ethel Mae Burton
Individual provider Active NPI Contractor · Durham, NC
NPI 1740635705 · NPPES record last updated Apr 27, 2016
Key facts
- NPI
- 1740635705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 32001509 (NC)
- Practice address
- 3607 Penn Dr
Durham, NC 27703-3656 - Phone
- (919) 598-5191
- NPI assigned
- Apr 27, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32001509 | NC | MD | Case Manager/Care Coordinator |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 32001509 | NC | |
| Contractor | 171W00000X | 32001509 | NC | Yes |
Addresses
Primary practice location
3607 Penn Dr
Durham, NC 27703-3656
Mailing address
3607 Penn Dr
Durham, NC 27703-3656
Phone (919) 598-5191
Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.