Individual
LORI BURRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2716 N TENAYA WAY FL 1, LAS VEGAS, NV 89128-0424
(702) 671-1111
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11000091
FL
207Q00000X
Family Medicine Physician
222740
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
525692
—
AZ
Enumeration date
11/09/2018
Last updated
09/27/2024
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