Provider Demographics
NPI:1740089952
Name:BURLISON, BREANNE MAY
Entity type:Individual
Prefix:
First Name:BREANNE
Middle Name:MAY
Last Name:BURLISON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:BREANNE
Other - Middle Name:MAY
Other - Last Name:YEHNERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2143 MORROW CT NW
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-1754
Mailing Address - Country:US
Mailing Address - Phone:503-949-6838
Mailing Address - Fax:
Practice Address - Street 1:2143 MORROW CT NW
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-1754
Practice Address - Country:US
Practice Address - Phone:503-949-6838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR110370374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula