Meshele A Bourdeau, RN, BSN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

667131-1 Issued in NY

Practice address

133 Aviation Rd
Queensbury, NY 12804-8206

Phone

(518) 798-0170

NPI assigned

Dec 21, 2017

Last updated

Dec 21, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• United Cerebral Palsy Association of the Tri-Counties, Inc.

  dba Prospect Child and Family Center

  • Early Intervention Provider Agency
  • Queensbury, NY
  • NPI 1518110618
  NPD (past)
• United Cerebral Palsy Association of the Tri-Counties, Inc.

  dba Prospect Center

  • Clinic/Center
  • Queensbury, NY
  • NPI 1952402448
  NPD (past)

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513814400000",
    "number": "1063928406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 494",
            "city": "LAKE LUZERNE",
            "state": "NY",
            "postal_code": "128460494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 AVIATION RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128048206",
            "telephone_number": "518-798-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURDEAU",
        "first_name": "MESHELE",
        "middle_name": "A",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-21",
        "last_updated": "2017-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "667131-1",
            "primary": true
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "667131-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chris Ann Bocko-Wettersten, MASTERS IN EDUCATION
• Frances C Bollinger, MD
• Sarah J Bolster
• Tara Angela Booth
• Steven John Borden, LMFT
• Mark Edwin Boyle, LICENSED OPHTHALMIC
• Mary Bozkurt
• Sarah Linn Branchfield, LMSW
• Patricia Susan Brandi, RN
• Caitlyn Breuer, PHARMD

• Registered Nurse in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; 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.