Shelby Nicole Burruss
Specialist/Technologist, Other, Surgical Assistant in Mount Nebo, WV. Individual provider (NPI-1).
NPI number1124860184
StatusActive
Last updated in NPPESJun 11, 2024
Details
- NPI
- 1124860184
- Entity type
- Individual (NPI-1)
- Name
- Shelby Nicole Burruss
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 11, 2024
- Certification date
- Jun 11, 2024
- Last updated
- Jun 11, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 246ZC0007X | Specialist/Technologist, Other, Surgical Assistant | 100272622 | WV | Yes |
Practice location
759 Summersville Lake RdMount Nebo, WV 26679-9203
Phone 304-640-6417
Mailing address
759 Summersville Lake RdMount Nebo, WV 26679-9203
Phone 304-640-6417
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