Active NPI
Jeffrey Michael Bourque, RN
- Registered Nurse
- Sitka, AK
National Provider Identifier
1841636636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 24384
- Practice address
- 222 Tongass Dr
Sitka, AK 99835-9416 - Phone
- (907) 966-2411
- NPI assigned
- May 20, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 24384 | AK | Primary |
Addresses
Primary practice location
222 Tongass Dr
Sitka, AK 99835-9416
Mailing address
PO Box 6364
Sitka, AK 99835-6364
Phone (907) 966-2411
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24384 | AK | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369008000000",
"number": "1841636636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6364",
"city": "SITKA",
"state": "AK",
"postal_code": "998356364",
"telephone_number": "907-966-2411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 TONGASS DR",
"city": "SITKA",
"state": "AK",
"postal_code": "998359416",
"telephone_number": "907-966-2411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURQUE",
"first_name": "JEFFREY",
"middle_name": "MICHAEL",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-20",
"last_updated": "2013-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AK",
"license": "24384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sitka, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.