MRS. LYDIA CORNELL BOURKE N.P. NPI 1578688560

NPI Information

  • NPI: 1578688560
  • Provider Name: MRS. LYDIA CORNELL BOURKE, N.P.
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2494 S ROCHESTER RD
    ROCHESTER HILLS, MI
    ZIP 48307
  • Phone: (248) 299-9850

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NPI Details

MRS. Lydia Cornell Bourke, N.P. is an adult health nurse practitioner in Rochester Hills, MI with 23 years of experience. MRS. Lydia Cornell Bourke, N.P. NPI is 1578688560. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2494 S ROCHESTER RD
ROCHESTER HILLS, MI
ZIP 48307-817
Phone: (248) 299-9850
Fax: (248) 299-9860

The NPI 1578688560 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)

The enumeration date for this NPI number is 3/20/2007 and was last updated on 8/28/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WM0705XRegistered NurseMedical-Surgical4704215985MICHIGANNo
2363LA2200XNurse PractitionerAdult Health4704215985MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14704215985OTHERMICHIGANNURSE PRACTITIONER LICEN
25008670700OTHERMICHIGANBCBS INDIVIDUAL #
35187136 10MEDICAIDMICHIGAN
44704215985OTHERMICHIGANNURSE LICENSE
5P12300001MEDICARE PINMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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