Provider Demographics
NPI:1750087623
Name:BURNHEIMER, KALEY ANN
Entity type:Individual
Prefix:
First Name:KALEY
Middle Name:ANN
Last Name:BURNHEIMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3488 W 122ND ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-3547
Mailing Address - Country:US
Mailing Address - Phone:216-772-5308
Mailing Address - Fax:
Practice Address - Street 1:3488 W 122ND ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-3547
Practice Address - Country:US
Practice Address - Phone:216-772-5308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-02
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker