Provider Demographics
NPI:1639514391
Name:BURRIS, CHEREECE AFRICA (LPN)
Entity Type:Individual
Prefix:
First Name:CHEREECE
Middle Name:AFRICA
Last Name:BURRIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 W 192ND ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-4118
Mailing Address - Country:US
Mailing Address - Phone:646-303-8348
Mailing Address - Fax:
Practice Address - Street 1:65 W 192ND ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-4118
Practice Address - Country:US
Practice Address - Phone:646-303-8348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY313099-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse