Emily Bourque, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND8574 Issued in FL

Practice address

123 Twin Meadow LN
Lafayette, LA 70508-8326

Phone

(727) 201-2495

NPI assigned

Aug 8, 2019

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": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1386299188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 TWIN MEADOW LN",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705088326",
            "telephone_number": "337-945-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 TWIN MEADOW LN",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705088326",
            "telephone_number": "727-201-2495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12209 Streambed Dr Fl 33579",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "FL",
            "postal_code": "335799309",
            "country_code": "US",
            "telephone_number": "727-201-2495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOURQUE",
        "first_name": "EMILY",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-08",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND8574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marc B Bourgeois, LPC
• Richard J Bourgeois, M.D.
• Trysten Theresa Bourgeois, BS, HS
• Janna Mae Bourque Cardona
• Daniel R Bourque, MD
• Hannah Gabrielle Bourque, DDS
• Jason Bourque, M.D.
• Jessie Bourque, CRNP
• Jodie Marie Duhon Bourque, CRNA
• Jordan Bourque, PT

• Registered Dietitian in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Registered Dietitian in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.