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General NPI Number Information
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NPI Number | 1538706536
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Entity Type | Individual
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Provider Name | JALISA BURNEY
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Gender | Female
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Dates
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Enumeration Date | 12/09/2019
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 25350 ROCKSIDE RD STE 100
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City | BEDFORD HEIGHTS
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State | OH
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Zip | 44146-7111
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Country | US
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Telephone | 216-961-8804
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Fax | 440-374-4965
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Provider Business Mailing Address
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Address Line | 3100 E 45TH ST STE 314
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City | CLEVELAND
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State | OH
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Zip | 44127-1095
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Country | US
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Telephone | 216-441-9622
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Fax | 888-460-4717
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | APRN.CNP.0032656
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License Number State | OH
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