Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Individual
PETER RALPH BOURQUE JR.
Active
Individual
PETER RALPH BOURQUE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
525838
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
5047
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402626
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402626-01
NY
Other
Enumeration date
09/13/2012
Last updated
10/01/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers