Individual
EDWINA BURRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2539 LAKESIDE DR, TOBYHANNA, PA 18466-3713
(718) 231-6252
Mailing address
2539 LAKESIDE DR, TOBYHANNA, PA 18466-3713
(718) 231-6252
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
281613
NY
Other
Enumeration date
01/26/2009
Last updated
01/26/2009
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