Borom, Shirley

Borom, Shirley is an individual health care provider with primary practice located at 1145 W 5Th Ave , Gary IN 46402-1704. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Other Service Providers / Case Manager/Care Coordinator. Nursing Service Providers / Registered Nurse is her primary health care specialty. Borom, Shirley can be contacted via phone (219) 882-5565.

Contact Information

Primary practice address
1145 W 5Th Ave Gary IN 46402-1704
Phone: (219) 882-5565
Fax: (219) 882-8213
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 28093654A Indiana
Other Service Providers / Case Manager/Care Coordinator 171M00000X 28093654A Indiana

Profile Details

NPI number 1649540261
LBN Legal business name Borom, Shirley
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 12th, 2012
Last updated Jan 12th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649540261 NPPES
Indiana MEDICAID 100142050A

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