MEDICARE: JOYCE BURNETT-LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	143972	OH

General Provider Information

NPI Number	:	1750839049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOYCE BURNETT-LPN

Provider Business Mailing Address
First Line	:	17021 HARVARD AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-2211
Country	:	US
Telephone Number	:	216-278-5955
Fax Number	:	216-400-7165

Provider Business Practice Location Address
First Line	:	17021 HARVARD AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-2211
Country	:	US
Telephone Number	:	216-278-5955
Fax Number	:	216-400-7165

Authorized Official
Title or Position	:	LPN HOMECARE NURSE
Name	:	MS. JOYCE BURNETT
Credential	:	LPN
Telephone Number	:	216-278-5955

Provider Enumeration Date	:	09/14/2016
Last Update Date	:	09/14/2016

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