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:
Health care specialties
| Specialty | Code | License # | 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 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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