Healthcare Provider Details

I. General information

NPI: 1780520460
Provider Name (Legal Business Name): KHRISTIE TYLER BURNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 E INDIANOLA AVE
YOUNGSTOWN OH
44507-1549
US

IV. Provider business mailing address

428 E INDIANOLA AVE
YOUNGSTOWN OH
44507-1549
US

V. Phone/Fax

Practice location:
  • Phone: 330-501-1764
  • Fax:
Mailing address:
  • Phone: 330-501-1764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: