Shannon Reigh Burnside
Technician, Personal Care Attendant in Glen White, WV. Individual provider (NPI-1).
NPI number1245096486
StatusActive
Last updated in NPPESFeb 26, 2024
Details
- NPI
- 1245096486
- Entity type
- Individual (NPI-1)
- Name
- Shannon Reigh Burnside
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 26, 2024
- Certification date
- Feb 22, 2024
- Last updated
- Feb 26, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747P1801X | Technician, Personal Care Attendant | – | – | Yes |
Practice location
109 Bellows LaneGlen White, WV 25849
Phone 304-539-3005
Mailing address
Po Box 561Sophia, WV 25921-0561
Phone 681-539-3005
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