Healthcare Provider Details

I. General information

NPI: 1245023787
Provider Name (Legal Business Name): DONNA JACQUELINE BURNS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2025
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

464 OLD ELK RAILROAD BED RD
FRAMETOWN WV
26623-7208
US

IV. Provider business mailing address

1429 LEE ST E
CHARLESTON WV
25301-1940
US

V. Phone/Fax

Practice location:
  • Phone: 681-238-9617
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: