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NPI 1114286838

NPI 1114286838 : KARETHA F BURNS STNA : DAYTON, OH

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General NPI Number Information
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    NPI Number           |    1114286838
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    Entity Type          |    Individual 
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    Provider Name        |    KARETHA F BURNS STNA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/15/2012
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    Last Update Date     |    05/15/2012
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Provider Practice Location Address
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    Address Line         |    1417 CANFIELD AVENUE 
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    City                 |    DAYTON
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    State                |    OH
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    Zip                  |    45406-4206
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    Country              |    US
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    Telephone            |    937-559-7315
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1417 CANFIELD AVE 
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    City                 |    DAYTON
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    State                |    OH
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    Zip                  |    45406-4206
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    Country              |    US
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    Telephone            |    937-559-7315
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    374U00000X
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    Taxonomy Name        |    Home Health Aide
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    License Number       |    401386900512
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    License Number State |    OH
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