Individual
SHELBY NICOLE BURRUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
759 SUMMERSVILLE LAKE RD, MOUNT NEBO, WV 26679-9203
(304) 640-6417
Mailing address
759 SUMMERSVILLE LAKE RD, MOUNT NEBO, WV 26679-9203
(304) 640-6417
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
100272622
WV
Other
Enumeration date
06/11/2024
Last updated
06/11/2024
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