Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blaze Burkenstock, PA

Individual provider Medical Physician Assistant · NPI 1386448728

Blaze Burkenstock, PA is a Medical Physician Assistant in Mandeville, Louisiana. Works from 2 locations. Licensed in Louisiana.

Licensed in
LA
In the registry since
2025
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

2040 N Causeway Blvd
Mandeville, LA 70471-3116
Phone: (985) 727-7676
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6600 Fleur De Lis Dr, New Orleans, LA 70124-1430 — (504) 888-2829

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 346049 (LA)

Record details

NPI number1386448728
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 3, 2025
Last updated in NPPESApril 3, 2025
Certification dateApril 3, 2025