Provider Demographics
NPI:1952912925
Name:BURR, WILMA LEIGH
Entity Type:Individual
Prefix:
First Name:WILMA
Middle Name:LEIGH
Last Name:BURR
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:PO BOX 328
Mailing Address - Street 2:
Mailing Address - City:BELINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26250-0328
Mailing Address - Country:US
Mailing Address - Phone:681-298-1234
Mailing Address - Fax:
Practice Address - Street 1:92 ALLEGHENY LN
Practice Address - Street 2:
Practice Address - City:PHILIPPI
Practice Address - State:WV
Practice Address - Zip Code:26416-9700
Practice Address - Country:US
Practice Address - Phone:304-457-5070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant