Individual
KIMBERLY C BOURASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, PMHNP-BC
Contact information
Practice address
327 MARSCHALL RD STE 250, SHAKOPEE, MN 55379-2666
(651) 769-6500
Mailing address
327 MARSCHALL RD STE 250, SHAKOPEE, MN 55379-2666
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9071
MN
Other
Enumeration date
08/06/2021
Last updated
05/06/2026
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