Provider Demographics
NPI:1265409080
Name:BURAS, JODI VINCENSFNP-BC (NP)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:VINCENSFNP-BC
Last Name:BURAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 GREENBRIER BLVD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7233
Mailing Address - Country:US
Mailing Address - Phone:985-893-5780
Mailing Address - Fax:985-893-0601
Practice Address - Street 1:160 GREENBRIER BLVD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7233
Practice Address - Country:US
Practice Address - Phone:985-893-5780
Practice Address - Fax:985-893-0601
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP03852363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1100706Medicaid
MS01252756Medicaid
LA4B873C773Medicare PIN
LA4B873C771Medicare PIN
MS01252756Medicaid
LA333020YH3UMedicare PIN