Individual
MRS. JENNIFER BURNER
Active
Individual
MRS. JENNIFER BURNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
WV00648
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477540268
—
WV
05
—
3810000531
—
WV
01
—
P00276763
RAILROAD MEDICARE
WV
01
—
WV1327C
MEDICARE PTAN
WV
Enumeration date
10/05/2005
Last updated
06/13/2024
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