Burton, Lisa Marie

Burton, Lisa Marie is an sole proprietor health care provider with primary practice located at 66 Elvira Ln , Fairfield CT 06824-1814. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Burton, Lisa Marie can be contacted via phone (786) 300-5776.

Contact Information

Primary practice address
66 Elvira Ln Fairfield CT 06824-1814
Phone: (786) 300-5776
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X RN1986612 Florida
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 006971 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 364SP0808X 1986612 Florida
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 6971 Connecticut

Profile Details

NPI number 1073594479
LBN Legal business name Burton, Lisa Marie
Credentials PHD,ARNP, PMHCNS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 11th, 2005
Last updated Aug 11th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073594479 NPPES
Connecticut MEDICAID 1073594479
Connecticut MEDICAID 306453101
Connecticut Other 119551
Connecticut Other 7500659
Connecticut Other 1073594479
Connecticut Other 1073594479
Connecticut Other P6402249
Connecticut Other 1073594479
Connecticut Other 742000000
Connecticut MEDICAID D400590987

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