Provider Demographics
NPI:1053695668
Name:BURNSED, BRYNNA KORIN (PA)
Entity type:Individual
Prefix:MRS
First Name:BRYNNA
Middle Name:KORIN
Last Name:BURNSED
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 BIENVILLE BLVD
Mailing Address - Street 2:REGIONAL CANCER CENTER
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-5705
Mailing Address - Country:US
Mailing Address - Phone:228-809-5251
Mailing Address - Fax:
Practice Address - Street 1:54 SGT PRENTISS DR
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-4726
Practice Address - Country:US
Practice Address - Phone:601-443-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA.780363A00000X
MSPA00286363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant