Individual
JENNIFER L. BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA053313
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0002887
STATE LICENSE
MD
01
—
MA053313
LICENSE
PA
Enumeration date
12/26/2006
Last updated
09/20/2024
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