Kerstin L Bourgeois, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

282586-1 Issued in NY

Practice address

98 Paradise Rd
Central Square, NY 13036-2253

Phone

(315) 668-2253

NPI assigned

Feb 27, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1013044387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 S RAILROAD ST",
            "address_2": "P.O. BOX 495",
            "city": "PARISH",
            "state": "NY",
            "postal_code": "131313370",
            "telephone_number": "315-625-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 PARADISE RD",
            "city": "CENTRAL SQUARE",
            "state": "NY",
            "postal_code": "130362253",
            "telephone_number": "315-668-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGEOIS",
        "first_name": "KERSTIN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "282586-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02749728",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn Michelle Akkoul, REGISTERED NURSE
• Alexandra Barber
• Virginia L Boak Glahn, LMHC
• Leslee Boissy-Weatherup, DDS
• Debbie J Boland, LPN
• Theodore Boyle, DPT
• Bridget a Frio OD PC
• Nicole M Broadwell
• Allison Amy Bronner
• Rita Marie Burton, LPN

• Licensed Practical Nurse in Central Square, NY
• Providers in Central Square, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.