Sheryl Sue Bourzac, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704180870 Issued in MI

Practice address

96 E 120TH St
Grant, MI 49327-8502

Phone

(231) 834-0444

Fax

(231) 834-0200

NPI assigned

Jan 5, 2006

Last updated

Jan 4, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1801874268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 E 120TH ST",
            "city": "GRANT",
            "state": "MI",
            "postal_code": "493278502",
            "telephone_number": "231-834-0444",
            "fax_number": "231-834-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 E 120TH ST",
            "city": "GRANT",
            "state": "MI",
            "postal_code": "493278502",
            "telephone_number": "231-834-0444",
            "fax_number": "231-834-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURZAC",
        "first_name": "SHERYL",
        "middle_name": "SUE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-05",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71002015A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704180870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200801560",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Baruch SLS, Inc. (Fountain View of Grant - Laboratory)
• Baruch SLS, Inc. (Fountain View Retirement Village)
• Melissa S Bayne, DO
• Miranda Bickel, D.M.D.
• Sarah Bottorff
• Kelly Jean Bulk, PA-C
• Michael Lee Buss, PHARMD
• Ashley Carpenter
• Scott A Chapman, PT
• Sarah Christine Clapp, R.PH.

• Family Nurse Practitioner in Grant, MI
• Providers in Grant, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.