Provider Demographics
NPI:1790386589
Name:BARTLEY, BIRDIE JANE
Entity Type:Individual
Prefix:
First Name:BIRDIE
Middle Name:JANE
Last Name:BARTLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BIRDIE
Other - Middle Name:JANE
Other - Last Name:EDMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:238 GEORGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:BELINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26250-7509
Mailing Address - Country:US
Mailing Address - Phone:304-823-1369
Mailing Address - Fax:
Practice Address - Street 1:238 GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:BELINGTON
Practice Address - State:WV
Practice Address - Zip Code:26250-7509
Practice Address - Country:US
Practice Address - Phone:304-823-1369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant