Provider Demographics
NPI:1689438996
Name:BURRIS, JUANAKEE (CLS, CD)
Entity Type:Individual
Prefix:
First Name:JUANAKEE
Middle Name:
Last Name:BURRIS
Suffix:
Gender:F
Credentials:CLS, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23655 E 114TH CT
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014
Mailing Address - Country:US
Mailing Address - Phone:405-640-0820
Mailing Address - Fax:
Practice Address - Street 1:23655 E 114TH CT
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74014
Practice Address - Country:US
Practice Address - Phone:405-640-0820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174H00000XOther Service ProvidersHealth Educator
No175T00000XOther Service ProvidersPeer Specialist