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:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 20185
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34204-0185
Mailing Address - Country:US
Mailing Address - Phone:419-238-9900
Mailing Address - Fax:941-238-9770
Practice Address - Street 1:1220 59TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-4154
Practice Address - Country:US
Practice Address - Phone:941-238-9900
Practice Address - Fax:941-238-9770
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN9311045363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAQ22985Medicare UPIN