Provider Demographics
NPI:1063268365
Name:BURRIS, BRITTANY (CNM)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:BURRIS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:PALACIOZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2625 E DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1431
Mailing Address - Country:US
Mailing Address - Phone:559-443-2682
Mailing Address - Fax:559-443-2681
Practice Address - Street 1:2210 E ILLINOIS AVE STE 408
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2184
Practice Address - Country:US
Practice Address - Phone:559-443-2694
Practice Address - Fax:559-443-2696
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236468367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife