Provider Demographics
NPI:1619615820
Name:BURNETTE-MEEK, SHANNON REE (RN)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:REE
Last Name:BURNETTE-MEEK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14127 TELLURIDE ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERSET
Mailing Address - State:SD
Mailing Address - Zip Code:57769-6210
Mailing Address - Country:US
Mailing Address - Phone:605-441-3569
Mailing Address - Fax:
Practice Address - Street 1:OYATE HEALTH CENTER
Practice Address - Street 2:3200 CANYON LAKE DR., STE. 1
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702
Practice Address - Country:US
Practice Address - Phone:605-355-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR055687163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse