Healthcare Provider Details

I. General information

NPI: 1942104856
Provider Name (Legal Business Name): ROBERT BURNS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 WALNUT ST
PARSONS WV
26287-1050
US

IV. Provider business mailing address

501 WILSON LN
ELKINS WV
26241-5216
US

V. Phone/Fax

Practice location:
  • Phone: 304-704-4657
  • Fax:
Mailing address:
  • Phone: 304-636-9326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: