Provider Demographics
NPI:1710585278
Name:BURTON, MAUREEN
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 LAKE CREST DR
Mailing Address - Street 2:
Mailing Address - City:ROAMING SHORES
Mailing Address - State:OH
Mailing Address - Zip Code:44084-9674
Mailing Address - Country:US
Mailing Address - Phone:216-379-3751
Mailing Address - Fax:
Practice Address - Street 1:1703 LAKE CREST DR
Practice Address - Street 2:
Practice Address - City:ROAMING SHORES
Practice Address - State:OH
Practice Address - Zip Code:44084-9674
Practice Address - Country:US
Practice Address - Phone:216-379-3751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No374U00000XNursing Service Related ProvidersHome Health Aide