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NPI Code Detail

MEDICARE: MISS SHAREE NICOLE BURROUGHS LPN

MEDICARE:  MISS SHAREE NICOLE BURROUGHS  LPN
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
1164W00000XLicensed Practical Nurse321032NY

General Provider Information

NPI Number : 1851764955
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS SHAREE NICOLE BURROUGHS LPN
Provider Business Mailing Address
First Line : 70 RAMONA PARK APT K
Second Line :
City : ROCHESTER
State : NY
Zip : 14615-3277
Country : US
Telephone Number : 585-512-9639
Fax Number :
Provider Business Practice Location Address
First Line : 70 RAMONA PARK APT K
Second Line :
City : ROCHESTER
State : NY
Zip : 14615-3277
Country : US
Telephone Number : 585-512-9639
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2015
Last Update Date : 11/11/2015

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Directions to “ MISS SHAREE NICOLE BURROUGHS LPN” Practice Location

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