ERICA RENEE BOURBON (NPI# 1376810598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376810598 |
| Entity Type | Individual |
| Full Name | ERICA RENEE BOURBON |
| Credential | ANP-BC |
| Practice Address |
17065 S. 71 Hwy Belton MO 64012 |
| Mailing Address |
36123 Schoolcraft Rd Livonia MI 48150-1216 |
| Practice Telephone | 8163481200 |
| Mailing Telephone | 9136601616 |
| Enumeration Date | 2011-11-17 |
| Last Update Date | 2018-04-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 77213 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
2008030659 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
17065 S. 71 HWY |
| City | BELTON |
| State | MO |
| Zip Code | 64012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952929614 | Brianna Buchheit | Dentist | 701 E Market Pkwy, Belton, MO 64012 | 2020-07-09 |
| 1518400290 | Ti-carnegie Village, LLC | Skilled Nursing Facility | 105 Bernard Drive, Belton, MO 64012 | 2016-11-29 |
| 1720432305 | Erin Washington | Specialist/Technologist | 801 W. North Ave, Belton, MO 64012 | 2016-04-20 |
| 1558726844 | Catherine Smith | Specialist/Technologist | 17065 Us-71, Belton, MO 64012 | 2015-12-31 |
| 1982077673 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 630 E. Markey Parkway, Belton, MO 64012 | 2015-11-04 |
| 1326484858 | Amanda Mccune | Nurse Practitioner | 1400 E. North Avenue, Belton, MO 64012 | 2013-05-10 |
| 1376895094 | Alex Sharifian,dds,. Belton Modern Dentistry, P.c | Dentist | 1731 East North Avenue, Belton, MO 64012 | 2012-10-04 |
| 1912260910 | Lindsey Belt Emergency Physicians, LLC | Emergency Medicine | 17065 S. 71 Highway, Belton, MO 64012 | 2012-06-25 |
| 1790073450 | Dale David Laird | Ophthalmology | 30 Hever Knoll, Loch Lloyd, MO 64012 | 2011-07-15 |
| 1417268798 | Elizabeth A Morrow | Physician Assistant | 17065 S Us 71 Hwy, Belton, MO 64012 | 2010-07-01 |
| Find all providers in zip 64012 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051870 | Melinda Davis-mcclendon | Nurse Practitioner | 2158 River Edge Dr, Belton, TX 76513-1429 | 2020-10-19 |
| 1861624843 | Nancy Flavin Stepanek | Nurse Practitioner | 17067 S Outer Rd Ste 100, Belton, MO 64012-2100 | 2009-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619285 | Jennifer Lee Speiser | Nurse Practitioner | 12545 Olive Blvd, Saint Louis, MO 63141-6311 | 2020-11-04 |
| 1215537220 | John Franklin Niswonger | Nurse Practitioner | 861 Canyon Trl, Jackson, MO 63755-4001 | 2020-10-28 |
| 1972119014 | Michael Christopher Hassert | Nurse Practitioner | 2290 Graystone Dr, Saint Charles, MO 63303-5159 | 2020-09-22 |
| 1265045264 | Andrea Jane Montgomery | Nurse Practitioner | 444 Honeysuckle Ln, Saint Louis, MO 63119-4521 | 2020-08-28 |
| 1710596424 | Clay Thornburg | Nurse Practitioner | 602 S Home St, Palmyra, MO 63461-1747 | 2020-07-28 |
| 1396362224 | Erin M Kehoe | Nurse Practitioner | 12973 Olive Blvd, Saint Louis, MO 63141-6149 | 2020-06-26 |
| 1508482506 | Matthew Dale Tieskoetter | Nurse Practitioner | 333 S Kirkwood Rd Ste 203, Saint Louis, MO 63122-6161 | 2020-06-25 |
| 1497391924 | Stephnie Michelle Wriedt | Nurse Practitioner | 1605 E Broadway Ste 250, Columbia, MO 65201-8031 | 2019-11-19 |
| 1861033615 | Benedicta Esi | Nurse Practitioner | 6024 Pennsylvania Ave, Saint Louis, MO 63111-2555 | 2019-10-02 |
| 1245896893 | Katina D Smith | Nurse Practitioner | 8820 Mcnulty Dr, Saint Louis, MO 63114-4146 | 2019-05-18 |
| Find all providers with the same taxonomy | ||||
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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.