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NPI Code Detail

MEDICARE: MISTY D BURGOS

MEDICARE: MISTY D BURGOS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1851102180
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISTY D BURGOS
Provider Business Mailing Address
First Line : PO BOX 12
Second Line :
City : PT PLEASANT
State : WV
Zip : 25550-0012
Country : US
Telephone Number : 304-675-2369
Fax Number :
Provider Business Practice Location Address
First Line : 101 2ND ST
Second Line :
City : PT PLEASANT
State : WV
Zip : 25550-1012
Country : US
Telephone Number : 304-675-2369
Fax Number : 304-675-2069
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2025
Last Update Date : 01/16/2025

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Directions to “ MISTY D BURGOS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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