Individual
MRS. LYDIA CORNELL BOURKE
Active
Individual
MRS. LYDIA CORNELL BOURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
4704215985
MI
363LA2200X
Adult Health Nurse Practitioner
Primary
4704215985
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704215985
NURSE LICENSE
MI
01
—
5008670700
BCBS INDIVIDUAL #
MI
05
—
5187136 10
—
MI
Enumeration date
03/20/2007
Last updated
08/28/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up