Provider Demographics
NPI:1528386125
Name:BURNS, AMANDA BETH COLEMAN (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:BETH COLEMAN
Last Name:BURNS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 70 BOX 65
Mailing Address - Street 2:
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:24986-9604
Mailing Address - Country:US
Mailing Address - Phone:304-667-9671
Mailing Address - Fax:
Practice Address - Street 1:202 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-1108
Practice Address - Country:US
Practice Address - Phone:304-647-6470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-07
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV50820163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool