LUCY BOURESSA (NPI# 1316311905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316311905 |
| Entity Type | Individual |
| Full Name | LUCY BOURESSA |
| Practice Address |
2105 E. Enterprise Ave 113 Appleton WI 54913 |
| Practice Telephone | 9209912561 |
| Practice Fax Number | 9209912563 |
| Mailing Telephone | 9209912561 |
| Mailing Fax Number | 9209912563 |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2015-11-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
2105 E. ENTERPRISE AVE 113 |
| City | APPLETON |
| State | WI |
| Zip Code | 54913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457994584 | Pamela J Andersen | Music Therapist | 245 N. Metro Drive, Appleton, WI 54913 | 2019-10-22 |
| 1396387510 | Nancy Sibley | Technician | N4423 County Road Ee, Appleton, WI 54913 | 2019-10-09 |
| 1659872240 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 3801 N. Richmond Street, Grand Chute, WI 54913 | 2018-02-28 |
| 1780116244 | Alison Pelger | Physician Assistant | 3916 North Intertech Court, Appleton, WI 54913 | 2017-04-03 |
| 1992189989 | Brittany Reinke | Physical Therapist | Walking and Wheeling, LLC, W4652 Glenn Street, Appleton, WI 54913 | 2015-07-20 |
| 1902280092 | Costco Wholesale Corporation | Pharmacy | 5401 W Integrity Way, Grand Chute, WI 54913 | 2015-07-17 |
| 1942646849 | Richard Anthony Mauthe | Pharmacist | 5401 W. Integrity Way, Neenah, WI 54913 | 2013-05-17 |
| 1750622163 | Tonya Janelle Wilderman | Pharmacist | 1400 N Mccarthy Rd, Apt 2, Grand Chute, WI 54913 | 2013-03-10 |
| 1295938777 | Jenna Marie Kadlec | Physical Therapist | 3916 N. Intertech Court, Appleton, WI 54913 | 2007-06-11 |
| 1275753659 | Apple Creek Oral Surgery, Sc | Dentist | 2410 East Evergreen Drive, Appleton, WI 54913 | 2007-04-26 |
| Find all providers in zip 54913 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427657329 | Tyler John Friis | Specialist/Technologist | 1514 E Keystone Ln, Appleton, WI 54913-7162 | 2020-10-21 |
| 1982252631 | Lorrie Ann Formella | Specialist/Technologist | 604 N Richmond St, Appleton, WI 54911-4659 | 2019-08-27 |
| 1700448933 | Cassandra Timmers | Specialist/Technologist | 5000 North Ballard Road, Appleton, WI 54913-5491 | 2019-07-09 |
| 1407411051 | Connor Larson | Specialist/Technologist | 2244 W Capitol Dr, Appleton, WI 54914-6828 | 2019-05-08 |
| 1609332303 | Hudson Bernard Kopp | Specialist/Technologist | 3601 N Marcos Ln, Appleton, WI 54911-8465 | 2019-02-18 |
| 1073084034 | Adam Larsen | Specialist/Technologist | 3117 E Drake Ln, Appleton, WI 54913-8000 | 2018-12-16 |
| 1871083527 | Mason Harold Schnese | Specialist/Technologist | W5625 Vans Rd, Appleton, WI 54915-9313 | 2018-05-17 |
| 1407225949 | Joshua Sanders | Specialist/Technologist | 618 W Seymour St, Appleton, WI 54915-1249 | 2015-09-15 |
| 1134597610 | Stuart Burkart | Specialist/Technologist | 610 N Badger Ave, Appleton, WI 54914-3405 | 2015-09-14 |
| 1295103893 | Kami Thews | Specialist/Technologist | 3016 E Greenleaf Dr, Appleton, WI 54913-7788 | 2015-09-13 |
| Find all providers in APPLETON | ||||
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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.