Provider Demographics
NPI:1073002861
Name:BURNEY, JANICE (RN)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:BURNEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1332 SENECA BLVD
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-2416
Mailing Address - Country:US
Mailing Address - Phone:440-429-8273
Mailing Address - Fax:
Practice Address - Street 1:1332 SENECA BLVD
Practice Address - Street 2:
Practice Address - City:BROADVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44147-2416
Practice Address - Country:US
Practice Address - Phone:440-429-8273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH441804163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse