Wanda Hix Bourne

Primary specialty

SpecialistTaxonomy code 174400000X

License

4901 Issued in FL

Practice address

Department of Veterans Affairs
1601 SW Archer Road
Gainesville, FL 32608

Phone

(352) 376-1611

NPI assigned

Sep 15, 2006

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

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992801393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8809 SW 111TH TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326085861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF VETERANS AFFAIRS",
            "address_2": "1601 SW ARCHER ROAD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32608",
            "telephone_number": "352-376-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNE",
        "first_name": "WANDA",
        "middle_name": "HIX",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "4901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Boulos, PHARMD
• Keri L Bourdage, PA-C
• Melanie Bourgeau, MD
• Ashley Story Bourne, DO
• Mitchell Bourne, MD
• Elias Mounir Bouyounes
• Jessica Alyse Bovio, PHARM.D.
• Jillian Ward Bowdoin, ARNP
• Rebecca Bowens
• Chelsea E Bower

• Specialist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.