Bourke, Lydia Cornell

Bourke, Lydia Cornell is an individual health care provider with primary practice located at 2494 S Rochester Rd , Rochester Hills MI 48307-3817. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Medical-Surgical, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Bourke, Lydia Cornell can be contacted via phone (248) 299-9850.

Contact Information

Primary practice address
2494 S Rochester Rd Rochester Hills MI 48307-3817
Phone: (248) 299-9850
Fax: (248) 299-9860
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Medical-Surgical 163WM0705X 4704215985 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 4704215985 Michigan

Profile Details

NPI number 1578688560
LBN Legal business name Bourke, Lydia Cornell
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2007
Last updated Aug 28th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578688560 NPPES
Michigan Other 5008670700 BCBS INDIVIDUAL #
Michigan Other 4704215985 BCBS INDIVIDUAL #
Michigan MEDICAID 5187136 10 BCBS INDIVIDUAL #
Michigan Other 4704215985 BCBS INDIVIDUAL #

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