Provider Demographics
NPI:1184383887
Name:BURRELL, SHERITA N (MEDICAL ASSISTING)
Entity type:Individual
Prefix:
First Name:SHERITA
Middle Name:N
Last Name:BURRELL
Suffix:
Gender:F
Credentials:MEDICAL ASSISTING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25731 WESTMORELAND DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-1283
Mailing Address - Country:US
Mailing Address - Phone:313-900-7690
Mailing Address - Fax:
Practice Address - Street 1:25731 WESTMORELAND DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-1283
Practice Address - Country:US
Practice Address - Phone:248-993-6390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-10
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical