Individual
BRENDA LYNN BOURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1226 W RIVER ST, BOISE, ID 83702-7049
(208) 331-1155
(208) 383-0190
Mailing address
PO BOX 95461, CLEVELAND, OH 44101-0033
(928) 669-3353
(928) 669-3131
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
00777
NM
133V00000X
Registered Dietitian
00864302
AZ
133V00000X
Registered Dietitian
Primary
D-742
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477728178
—
ID
Enumeration date
04/24/2008
Last updated
08/31/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us