Individual
BARBARA BOURDESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
119 WALNUT ST, JOHNSTOWN, PA 15901-1625
(814) 534-0745
(814) 536-5431
Mailing address
158 MILLERS RD, SIDMAN, PA 15955-3508
(814) 534-0745
(814) 536-5431
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP007489
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012166170001
—
PA
01
—
1587977
HIGHMARK
PA
01
—
520197
VALUEOPTIONS
PA
Enumeration date
10/10/2006
Last updated
09/25/2018
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