=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831065564
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JUST LEAN ON ME, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/10/2025
-----------------------------------------------------
Last Update Date | 10/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 202 MILFORD ST APT 123
-----------------------------------------------------
City | TUPELO
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38801-4649
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-401-9890
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 202 MILFORD ST APT 123
-----------------------------------------------------
City | TUPELO
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38801-4649
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-401-9890
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | BONNIE NICOLE BURKS
-----------------------------------------------------
Credential | LPN
-----------------------------------------------------
Telephone | 318-334-1235
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------