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NPI Code Detail

MEDICARE: BREANNA BURRIS APRN

MEDICARE: BREANNA BURRIS APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPRN11033274FL

General Provider Information

NPI Number : 1871335208
Entity Type Code : Individual
Provider Name (Legal Business Name) : BREANNA BURRIS APRN
Provider Business Mailing Address
First Line : PO BOX 361095
Second Line :
City : MELBOURNE
State : FL
Zip : 32936-1095
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 336 COGAN DR SE
Second Line :
City : PALM BAY
State : FL
Zip : 32909-6869
Country : US
Telephone Number : 321-462-4001
Fax Number : 321-622-6400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2024
Last Update Date : 06/07/2024

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Directions to “ BREANNA BURRIS APRN” Practice Location

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