Provider Demographics
NPI:1306942347
Name:BURNER, VICTORIA GALLEY (MED CCCA)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:GALLEY
Last Name:BURNER
Suffix:
Gender:F
Credentials:MED CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243A NEFF AVENUE
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3482
Mailing Address - Country:US
Mailing Address - Phone:540-432-0071
Mailing Address - Fax:540-432-6079
Practice Address - Street 1:243A NEFF AVENUE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3482
Practice Address - Country:US
Practice Address - Phone:540-432-0071
Practice Address - Fax:540-432-6079
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201000593237600000X, 231H00000X
VA2101001152237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009450483Medicaid
VA010244668Medicaid
VA009108629Medicaid
VA010244684Medicaid
VA118844OtherOPTIMA INS
VA187485OtherANTHEM WOODSTOCK LOCATION
VA434342OtherANTHEM INS HARRISONBURG
VA49486OtherOPTIMA INS
VA148358OtherSOUTHERN HEALTH SERVICES