Provider Demographics
NPI:1588933600
Name:SHAMBURGER, CHERYL (RN,CFCN)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:SHAMBURGER
Suffix:
Gender:F
Credentials:RN,CFCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:368 SCARBROUGH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:RICHLAND
Mailing Address - State:MS
Mailing Address - Zip Code:39218-9038
Mailing Address - Country:US
Mailing Address - Phone:601-845-4946
Mailing Address - Fax:601-845-4946
Practice Address - Street 1:368 SCARBROUGH ST
Practice Address - Street 2:SUITE B
Practice Address - City:RICHLAND
Practice Address - State:MS
Practice Address - Zip Code:39218-9038
Practice Address - Country:US
Practice Address - Phone:601-845-4946
Practice Address - Fax:601-845-4946
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-19
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR875722163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse