MELANIE R BOURKE (NPI# 1588051213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588051213 |
| Entity Type | Individual |
| Full Name | MELANIE R BOURKE |
| Credential | RN, PHN |
| Practice Address |
3800 Park Nicollet Blvd St Louis Park MN 55416-2527 |
| Practice Telephone | 9529933123 |
| Practice Fax Number | 9529933286 |
| Mailing Telephone | 9529933123 |
| Mailing Fax Number | 9529933286 |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2018-12-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | R 218003-8 | MN | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
5275 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5775 Wayzata Blvd Ste 255, St Louis Park, MN 554161275 | 6122738710 | 6122738727 |
| Street Address |
3800 PARK NICOLLET BLVD |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55416-2527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861497745 | Mary C Fields | Psychiatry & Neurology | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2005-06-16 |
| 1316552383 | Emily Elizabeth Morimoto | Psychologist | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2020-09-15 |
| 1245862846 | Caara Hirsch Leintz | Physician Assistant | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2020-02-11 |
| 1477102770 | Kyja Foster | Counselor | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-09-09 |
| 1750938411 | Abigale Jayne Harris | Social Worker | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-08-19 |
| 1912552076 | Michael Patrick Miller | Dietitian, Registered | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-08-06 |
| 1083277743 | Jessica B Arndt | Social Worker | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-04-18 |
| 1043785157 | Jerry L Juhl | Physical Therapist | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2018-10-05 |
| 1437624558 | Chandler Elise Domian Ommen | Occupational Therapist | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2018-10-04 |
| 1861977472 | Sarah Ruth Tupper | Nurse Practitioner | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2018-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427601483 | Angela M Melland | Nurse Practitioner | 1550 Utica Ave S Ste 450, St Louis Park, MN 55416-3678 | 2019-07-18 |
| 1891309969 | Loveline N Ngu | Nurse Practitioner | 1155 Ford Rd, St Louis Park, MN 55426-1099 | 2020-09-04 |
| 1811537632 | Tatum Karos | Nurse Practitioner | 4027 County Road 25, St Louis Park, MN 55416-2629 | 2020-01-09 |
| 1497283253 | John Leland Mckinley | Nurse Practitioner | 3525 Monterey Dr, St Louis Park, MN 55416 | 2017-05-24 |
| 1194167643 | Muriel Denise Philipp | Nurse Practitioner | 1155 Ford Rd, Suite B, St Louis Park, MN 55426-1099 | 2013-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285234435 | Hawa Warsame Ali | Nurse Practitioner | 2650 Portland Ave, Minneapolis, MN 55407-1011 | 2020-10-27 |
| 1962009548 | Emily Ongaga | Nurse Practitioner | 43 10 Parkview Circle, Anoka, MN 55303 | 2020-10-06 |
| 1811504038 | Rita Jane Giglio | Nurse Practitioner | 201 Stade Ln, Fairmont, MN 56031-3227 | 2020-09-30 |
| 1568077725 | Linda Mongare | Nurse Practitioner | 3659 Tower Pond Dr, Anoka, MN 55303-8302 | 2020-09-14 |
| 1366056806 | Associates In Mental Health and Addiction Services. P.l.l.c | Nurse Practitioner | 166 W 3rd St Ste 202, Winona, MN 55987-6591 | 2020-09-02 |
| 1891308813 | Chelsey Paulson | Nurse Practitioner | 228 Krays Mill Rd, Cold Spring, MN 56320-4563 | 2020-08-28 |
| 1417560681 | Amy Engle | Nurse Practitioner | 1125 Se 8th Street, Willmar, MN 56201 | 2020-08-28 |
| 1609488964 | Heather Mantsch | Nurse Practitioner | 1900 Silver Lake Rd Nw Ste 100, New Brighton, MN 55112-1786 | 2020-08-18 |
| 1326659210 | Monsurat Oluwa-okougbo | Nurse Practitioner | 1565 11th Ave, Newport, MN 55055-1650 | 2020-08-13 |
| 1629687124 | Justin Robert Wirth | Nurse Practitioner | 4801 Veterans Dr # 111, Saint Cloud, MN 56303-2015 | 2020-07-30 |
| Find all providers with the same taxonomy | ||||
| City | ST LOUIS PARK |
| Zip Code | 55416 |
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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.