Healthcare Provider Details

I. General information

NPI: 1053041244
Provider Name (Legal Business Name): JASMINE BURNO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2022
Last Update Date: 06/12/2022
Certification Date: 06/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 ACADEMY AVE
CINCINNATI OH
45205-1623
US

IV. Provider business mailing address

812 ACADEMY AVE
CINCINNATI OH
45205-1623
US

V. Phone/Fax

Practice location:
  • Phone: 215-651-0388
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: