Provider Demographics
NPI:1447901277
Name:BURAS, BROOKLYN BLANCHE (DNP, FNP - BC)
Entity type:Individual
Prefix:DR
First Name:BROOKLYN
Middle Name:BLANCHE
Last Name:BURAS
Suffix:
Gender:F
Credentials:DNP, FNP - BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 N EDGEMONT ST APT 3
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-6249
Mailing Address - Country:US
Mailing Address - Phone:504-287-6387
Mailing Address - Fax:
Practice Address - Street 1:566 SAINT CHARLES DR
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-3953
Practice Address - Country:US
Practice Address - Phone:805-449-8781
Practice Address - Fax:805-449-4224
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95019697363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily