Provider Demographics
NPI:1427432392
Name:BURKS, JAMIE LEIGH (CFNP)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEIGH
Last Name:BURKS
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2000 TYBEE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-4171
Mailing Address - Country:US
Mailing Address - Phone:337-433-7272
Mailing Address - Fax:337-433-0730
Practice Address - Street 1:2000 TYBEE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-4171
Practice Address - Country:US
Practice Address - Phone:337-433-7272
Practice Address - Fax:337-433-0730
Is Sole Proprietor?:No
Enumeration Date:2015-07-10
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAAP08559363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily