MEDICARE: MS. EILEEN C SHERBURNE MSN, FNP, CNS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1187-033	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194836460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EILEEN C SHERBURNE MSN, FNP, CNS

Provider Business Mailing Address
First Line	:	9000 W WISCONSIN AVE
Second Line	:	MS 616 PO BOX 1997
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-3518
Country	:	US
Telephone Number	:	414-266-2063
Fax Number	:	414-266-3622

Provider Business Practice Location Address
First Line	:	9000 W WISCONSIN AVE
Second Line	:	MS 616
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-3518
Country	:	US
Telephone Number	:	414-266-2063
Fax Number	:	414-266-3622

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	01/31/2020

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