Healthcare Provider Details

I. General information

NPI: 1154247328
Provider Name (Legal Business Name): GARNET MARIE BURGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 JAMIES ALY
HOLDEN WV
25625
US

IV. Provider business mailing address

PO BOX 808
HOLDEN WV
25625-0808
US

V. Phone/Fax

Practice location:
  • Phone: 304-601-3112
  • Fax:
Mailing address:
  • Phone: 304-601-3112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: