Provider Demographics
NPI:1922165208
Name:BURBANK, SHARI A (APRN)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:A
Last Name:BURBANK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 49TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-6625
Mailing Address - Country:US
Mailing Address - Phone:813-915-5459
Mailing Address - Fax:727-201-4147
Practice Address - Street 1:900 49TH ST N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-6625
Practice Address - Country:US
Practice Address - Phone:813-915-5459
Practice Address - Fax:727-201-4147
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9311045363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAQ22985Medicare UPIN