Provider Demographics
NPI:1366809691
Name:BURNETT, SHARRIKA
Entity type:Individual
Prefix:
First Name:SHARRIKA
Middle Name:
Last Name:BURNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4817 SPRUCE PEAK RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-6559
Mailing Address - Country:US
Mailing Address - Phone:980-219-3495
Mailing Address - Fax:
Practice Address - Street 1:4817 SPRUCE PEAK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278-6559
Practice Address - Country:US
Practice Address - Phone:980-219-3495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-17
Last Update Date:2016-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker