Provider Demographics
NPI:1154733533
Name:BURNS, SHEWANNA K (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:SHEWANNA
Middle Name:K
Last Name:BURNS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 N SUMMIT ST FL 7
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-2615
Mailing Address - Country:US
Mailing Address - Phone:800-427-1902
Mailing Address - Fax:419-531-2664
Practice Address - Street 1:37603 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-5923
Practice Address - Country:US
Practice Address - Phone:800-427-0902
Practice Address - Fax:419-531-2664
Is Sole Proprietor?:No
Enumeration Date:2014-05-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH15884363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health