Barbra Ann Bordeaux, RN
Individual provider Active NPI Registered Nurse · Rapid City, SD
NPI 1710216031 · NPPES record last updated Dec 16, 2009
Key facts
- NPI
- 1710216031
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- R032559 (SD)
- Practice address
- 3200 Canyon Lake Dr
Rapid City, SD 57702-8114 - Phone
- (605) 355-2500
- Fax
- (605) 355-2553
- NPI assigned
- Dec 16, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R032559 | SD | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R032559 | SD | Yes |
Addresses
Primary practice location
3200 Canyon Lake Dr
Rapid City, SD 57702-8114
Mailing address
3200 Canyon Lake Dr
Rapid City, SD 57702-8114
Phone (605) 355-2500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5549050 | Medicaid | SD | |
| 0140070 | Other | SD | MEDCAID INPATIENT |
Other providers in Rapid City, SD
- Sheyenne Grace Bond
- Tanner Allen Bond
- Amy Bonkoski
- Jennifer Nicole Bonner
- Laura A Bonsness
- Lori Ann Borella
- Mercedes Jo Borgen
- Trista Marie Borgwardt
- Paul A Bormes
- Jessica Boschee
All providers in Rapid City, SD · Registered Nurse in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.