Provider Demographics
NPI:1992435408
Name:BURCH, CYNTHIA LYNNE
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LYNNE
Last Name:BURCH
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 1:1210 E DUPONT AVE
Mailing Address - Street 2:
Mailing Address - City:BELLE
Mailing Address - State:WV
Mailing Address - Zip Code:25015-1748
Mailing Address - Country:US
Mailing Address - Phone:681-280-9222
Mailing Address - Fax:
Practice Address - Street 1:1210 E DUPONT AVE
Practice Address - Street 2:
Practice Address - City:BELLE
Practice Address - State:WV
Practice Address - Zip Code:25015-1748
Practice Address - Country:US
Practice Address - Phone:681-280-9222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant