Provider Demographics
NPI:1528546538
Name:BURKETT, SHERICA ANN
Entity Type:Individual
Prefix:
First Name:SHERICA
Middle Name:ANN
Last Name:BURKETT
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 1:1002 ANDREW ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44307-1010
Mailing Address - Country:US
Mailing Address - Phone:330-643-7022
Mailing Address - Fax:
Practice Address - Street 1:1002 ANDREW ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-1010
Practice Address - Country:US
Practice Address - Phone:330-643-7022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400363240504376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide