Provider Demographics
NPI:1578834776
Name:BURROWES, SHELLEY PATRICIA (FNP)
Entity Type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:PATRICIA
Last Name:BURROWES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 EASTERN PARKWAY
Mailing Address - Street 2:APT 11
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213
Mailing Address - Country:US
Mailing Address - Phone:508-579-8541
Mailing Address - Fax:
Practice Address - Street 1:1199 EASTERN PARKWAY
Practice Address - Street 2:APT 11
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213
Practice Address - Country:US
Practice Address - Phone:508-579-8541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2013-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY337095363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily