Jacqueline Bourdeau

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

337346 Issued in NY

Practice address

2415 Newkirk Ave
Brooklyn, NY 11226-7622

Phone

(646) 712-3243

NPI assigned

Sep 14, 2020

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

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": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1366057614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 NEWKIRK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112267622",
            "telephone_number": "646-712-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 NEWKIRK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112267622",
            "telephone_number": "646-712-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURDEAU",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "337346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kourtney Lee Bouma
• Adrienna Boumoussa, MD
• Viktoria Bounitch, DDS
• Yves-Laura Bouquet, LPN
• Fritzner Bourdeau, M.D.
• Juana Bourdeau
• Monique Bourdeau, RPH
• Renee Jean Bourgault, PA-C
• Shady Bourham
• Sandra Bourjolly

• Licensed Practical Nurse in Brooklyn, NY
• Providers in Brooklyn, 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 Sep 14, 2020; 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.