=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922165208
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHARI A BURBANK APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/03/2007
-----------------------------------------------------
Last Update Date | 04/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1220 59TH ST W
-----------------------------------------------------
City | BRADENTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34209-4154
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-238-9900
-----------------------------------------------------
Fax | 941-238-9770
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 20185
-----------------------------------------------------
City | BRADENTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34204-0185
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-238-9900
-----------------------------------------------------
Fax | 941-238-9770
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APRN9311045
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------