Erika Leigh Bourdeaux, DNP, RN, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

7358-33 Issued in WI

Practice address

2825 Prairie Ave
Beloit, WI 53511-1844

Phone

(608) 363-5500

NPI assigned

Nov 16, 2016

Last updated

Nov 16, 2016By 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 1

Addresses

Other names 1

• Erika Leigh Kipp Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

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.

• Mercy Health System Corporation

  dba Mercy Beloit Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Beloit, WI
  • NPI 1619000437
  NPD (past)

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

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1487196895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 PRAIRIE AVE",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111844",
            "telephone_number": "608-363-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 PRAIRIE AVE",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111844",
            "telephone_number": "608-363-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURDEAUX",
        "first_name": "ERIKA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "DNP, RN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-16",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "7358-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIKA",
            "last_name": "KIPP",
            "middle_name": "LEIGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Loria R. Boone
• Nathaniel S Bothfeld, PT
• Bouc Family Wellness Center, LLC
• Geoffrey Thomas Bouc, MD
• Peter Zenithen Bouc
• Susan G Bower, MSN, RN, APNP
• Kate E Bowgren, SAC-IT
• Erin L Bown, MSN, RN
• Tammy Jo Boxleitner, APN
• Savannah Marie Boyd

• Pediatric Nurse Practitioner in Beloit, WI
• Providers in Beloit, WI by specialty
• Pediatric Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; 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.