REBECCA LYNN BOURBON (NPI# 1003973231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003973231 |
| Entity Type | Individual |
| Full Name | REBECCA LYNN BOURBON |
| Credential | P.A.-C |
| Practice Address |
4005 High Resort Blvd Se Rio Rancho NM 87124-5906 |
| Mailing Address |
Po Box 26666 Presbyterian Healthcare Services Albuquerque NM 87125-6666 |
| Practice Telephone | 5054626000 |
| Practice Fax Number | 5054628472 |
| Mailing Telephone | 5059236770 |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2015-09-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 92-PA09 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
92-PA09 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | PA920091 | 05 |
| Street Address |
4005 HIGH RESORT BLVD SE |
| City | RIO RANCHO |
| State | NM |
| Zip Code | 87124-5906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992701759 | Doris Kay Gonzales | Nurse Practitioner | 4005 High Resort Blvd Se, Pmg Rio Rancho High Resort 4005, Rio Rancho, NM 87124-5906 | 2005-06-24 |
| 1770149395 | Kristyn Bilak | Registered Nurse | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2019-05-20 |
| 1770067167 | Jacqueline S Guinn | Family Medicine | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2018-09-20 |
| 1073033650 | David Allen Zarikta | Nurse Practitioner | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2017-06-23 |
| 1720538390 | Ludmila Zlatkin | Nurse Practitioner | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2016-10-07 |
| 1144774712 | Ebubechukwu Njemanze | Internal Medicine | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2016-08-11 |
| 1578016994 | Erin Nicole Etzel | Psychologist | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2016-08-02 |
| 1467801399 | Simone Green | Pediatrics | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2016-06-10 |
| 1003275959 | Shae Ray | Registered Nurse | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2016-02-21 |
| 1801252895 | Julio Cesar Hernandez Roman | Physician Assistant | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2016-01-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740895648 | Dallon Knight | Pharmacist | 1115 Nm-528 Se, Rio Rancho, NM 87124 | 2020-09-09 |
| 1447875133 | Paul D Phillip | Counselor | 1207 Golf Course Rd Ne, Suite C, Rio Rancho, NM 87124 | 2020-06-09 |
| 1093341810 | Clearsky Rehabilitation Hospital of Rio Rancho LLC | Rehabilitation Hospital | 2401 Westside Blvd, Rio Rancho, NM 87124 | 2020-03-13 |
| 1841840345 | Debra English | Technician | 2001 Yucca St Se, Rio Rancho, NM 87124 | 2019-09-17 |
| 1114589322 | Counseling Connections, LLC | Counselor | 2600 Istle Rd Ne, Rio Rancho, NM 87124 | 2019-07-08 |
| 1417414996 | Kimberly Lovette Lorenzini | Counselor | Rio Rancho Family Counseling, 1340 Monterrey Rd, Rio Rancho, NM 87124 | 2019-02-21 |
| 1225507197 | Speech and Language Possibilities, LLC | Audiologist | 273 Tigris Road Ne, Rio Rancho, NM 87124 | 2018-11-20 |
| 1063997823 | Cindy Pendrey, LLC | Clinic/Center | 2103 Golf Course Rd Se, Suite A, Rio Rancho, NM 87124 | 2018-09-27 |
| 1972094324 | Calmar Inc. | Durable Medical Equipment & Medical Supplies | 2003 Southern Blvd Ne, Suite 123, Rio Rancho, NM 87124 | 2018-05-22 |
| 1013404581 | New Mexico Dental Clinics LLC | Dentist | 1594 Sara Rd Se Ste C, Rio Rancho, NM 87124 | 2018-04-19 |
| Find all providers in zip 87124 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306478870 | Holly Howe | Physician Assistant | 2300 Grande Blvd Se # 4045, Rio Rancho, NM 87124-1755 | 2020-02-12 |
| 1033752357 | Daniel Ray Spohn | Physician Assistant | 1630 Rio Rancho Dr Se, Rio Rancho, NM 87124-1587 | 2019-10-18 |
| 1124557202 | Amber Menke | Physician Assistant | 2101 Unser Blvd Se, Rio Rancho, NM 87124-6378 | 2017-06-12 |
| 1659774537 | Heather Armes | Physician Assistant | 1001 New Mexico Hwy 528 Se, Rio Rancho, NM 87124-1001 | 2014-10-06 |
| 1003183187 | Kimberley B. Oldewage | Physician Assistant | 1350 Jackie Road Ste 101, Westside Family Medicine, Rio Rancho, NM 87124-1519 | 2011-11-17 |
| 1295028363 | Jennifer Urbina | Physician Assistant | 1001 Nm 528, Rio Rancho, NM 87124-1057 | 2011-05-24 |
| 1356322762 | Imtiaz A Malik | Physician Assistant | 2400 Unser Blvd Se, Rio Rancho, NM 87124-4740 | 2005-11-11 |
| 1245759463 | Victoria Freeman | Physician Assistant | 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144 | 2017-09-19 |
| 1770930521 | Cara Doogan | Physician Assistant | 2400 Unser Blvd Se, Rio Rancho, NM 87124-4740 | 2016-05-23 |
| 1053795534 | Alisha Plummer | Physician Assistant | 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144-2100 | 2015-07-15 |
| Find all providers in RIO RANCHO | ||||
| City | RIO RANCHO |
| Zip Code | 87124 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.