Provider Demographics
NPI:1780469312
Name:BURTON, SHARDE' (MPH)
Entity type:Individual
Prefix:
First Name:SHARDE'
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 S MARTIN LUTHER KING JR BLVD # 105
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-2939
Mailing Address - Country:US
Mailing Address - Phone:231-660-1677
Mailing Address - Fax:
Practice Address - Street 1:6138 HAAG RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-5450
Practice Address - Country:US
Practice Address - Phone:517-719-0872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula