Provider Demographics
NPI:1548490337
Name:BURROW, SHAWN L (NP-C)
Entity type:Individual
Prefix:MRS
First Name:SHAWN
Middle Name:L
Last Name:BURROW
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3012 APPLEFORD DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-8801
Mailing Address - Country:US
Mailing Address - Phone:804-677-4719
Mailing Address - Fax:
Practice Address - Street 1:24 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803
Practice Address - Country:US
Practice Address - Phone:804-732-0372
Practice Address - Fax:804-732-3435
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2019-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169970363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024169970OtherLICENSED NURSE PRACTITIONER
VA0001119878OtherREGISTERED NURSE