Active NPI
Jane Lynn Bourgeois, RN
- Registered Nurse
- Albuquerque, NM
National Provider Identifier
1972741031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R31111
- Practice address
- 1057 Las Golondrinas CT NW
Albuquerque, NM 87107-5280 - Phone
- (505) 343-1235
- NPI assigned
- Jan 28, 2009
- Sex
- Female
- 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 | R31111 | NM | Primary |
Addresses
Primary practice location
1057 Las Golondrinas CT NW
Albuquerque, NM 87107-5280
Mailing address
1057 Las Golondrinas CT. NW
Albuquerque, NM 87107
Phone (505) 343-1235
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R31111 | Other | NM | RN |
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 |
|---|---|---|---|
| R31111 | NM | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233100800000",
"number": "1972741031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1057 LAS GOLONDRINAS CT. NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87107",
"telephone_number": "505-343-1235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1057 LAS GOLONDRINAS CT NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871075280",
"telephone_number": "505-343-1235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURGEOIS",
"first_name": "JANE",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-28",
"last_updated": "2009-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NM",
"license": "R31111",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN",
"identifier": "R31111",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.