MR. PETER R BOURQUE JR. (NPI# 1972853299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972853299 |
| Entity Type | Individual |
| Full Name | MR. PETER R BOURQUE JR. |
| Credential | APRN |
| Practice Address |
40 Avon Meadow Lane Avon CT 06001 |
| Practice Telephone | 8609909870 |
| Mailing Telephone | 8609909870 |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2012-09-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
5047 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
40 AVON MEADOW LANE |
| City | AVON |
| State | CT |
| Zip Code | 06001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366483372 | Daniel Thomas Fitzpatrick | Optometrist | 40 Avon Meadow Lane, Avon, CT 06001-3753 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285247338 | Alledran Med LLC | Durable Medical Equipment & Medical Supplies | 47 Avonwood Road, Unit #218, Avon, CT 06001 | 2020-08-28 |
| 1265053391 | 001care Inc | In Home Supportive Care | 20 Tower Lane, Avon, CT 06001 | 2020-04-29 |
| 1649813783 | Peoplesdental, P.C. | Dentist | 20 W Avon Rd Ste 104, Avon, CT 06001 | 2019-10-22 |
| 1740822063 | I E Consulting, LLC | Home Health | 1-5 East Main Street, Avon, CT 06001 | 2019-10-09 |
| 1598324261 | Prima Labs, LLC | Orthopaedic Surgery | Dr. Alexandra 58, Kezmarok, SLOVAKIA 06001 | 2019-06-06 |
| 1194220996 | Theresa L. Hixson | Social Worker | 152 Simsbury Rd., Building 9, Avon, CT 06001 | 2018-03-26 |
| 1851809974 | Kathleen Ann Subasic | Occupational Therapist | 19 Stockbridge Dr, Avon, CT 06001 | 2018-01-11 |
| 1801254297 | Vanessa Brodie | Psychologist | 395 W Avon Rd Ste 1, Avon, CT 06001 | 2016-02-01 |
| 1346614468 | Bryan Lilley | Physical Therapist | 34 Dale Rd., 202, Avon, CT 06001 | 2015-12-01 |
| 1073947446 | Rahel K. Saroff Counseling Services LLC | Counselor | 7 Towpath Lane, Avon, CT 06001 | 2013-08-21 |
| Find all providers in zip 06001 | ||||
| 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 |
|---|---|---|---|---|
| 1316555386 | Comfort of Your Home Psychiatry | Nurse Practitioner | 175 Hurd Lane, Unit 3212, Avon, CO 81620 | 2020-07-16 |
| 1336299916 | Laura Ann Kramer | Nurse Practitioner | 80 W Avon Rd, Avon, CT 06001-3534 | 2007-01-12 |
| 1427056472 | Debra V Johnson | Nurse Practitioner | 35 Tower Ln, Unit 102, Avon, CT 06001-4237 | 2005-07-13 |
| 1134735210 | Eulah Lacey | Nurse Practitioner | 21 Waterville Rd, Avon, CT 06001-2097 | 2020-09-23 |
| 1497366942 | Gary Wharton | Nurse Practitioner | 4265 E Main St, Avon, IN 46123-9174 | 2020-08-10 |
| 1093277709 | Debra V Johnson, Aprn | Nurse Practitioner | 35 Tower Ln, Unit 102, Avon, CT 06001-4237 | 2019-04-02 |
| 1487111274 | Ann Shackelford Reeves | Nurse Practitioner | 1115 Ronald Reagan Pkwy, Avon, IN 46123-6910 | 2019-02-27 |
| 1003385451 | Sasha Perry | Nurse Practitioner | 21 Waterville Rd, Avon, CT 06001-2097 | 2018-11-15 |
| 1437674421 | Carie Ann Ylanan | Nurse Practitioner | 6655 E Us Highway 36, Avon, IN 46123-8923 | 2017-08-10 |
| 1023531688 | Megan Burton | Nurse Practitioner | 6655 E Us Highway 36, Avon, IN 46123-8923 | 2017-07-25 |
| Find all providers in AVON | ||||
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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.