Provider Demographics
NPI:1336677319
Name:BURR, BRANDON (FNP, PMHNP)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:BURR
Suffix:
Gender:M
Credentials:FNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 FORREST DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-1901
Mailing Address - Country:US
Mailing Address - Phone:757-528-8881
Mailing Address - Fax:757-528-8881
Practice Address - Street 1:21 FORREST DR
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-1901
Practice Address - Country:US
Practice Address - Phone:757-528-8881
Practice Address - Fax:757-528-8881
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024174879363LF0000X, 363LP0808X
MARN2359804363LP0808X
MDAC002189363LP0808X
NVCS37757363LP0808X
FLAPRN11006676363LP0808X
DCRN1056068363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily