MRS. MAUREEN DERMODY BOURIS RN CDE NPI 1710922851

NPI Information

  • NPI: 1710922851
  • Provider Name: MRS. MAUREEN DERMODY BOURIS, RN, CDE
  • Classification: Registered Nurse - 163WD0400X
  • Specialization: Diabetes Educator
  • Entity Type: Individual
  • Address: 21 PARIS ST
    PAWTUCKET, RI
    ZIP 02860
  • Phone: (401) 728-6811

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NPI Details

MRS. Maureen Dermody Bouris, RN, CDE is a diabetes educator registered nurse in Pawtucket, RI. MRS. Maureen Dermody Bouris, RN, CDE NPI is 1710922851. 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:

21 PARIS ST
PAWTUCKET, RI
ZIP 02860-128
Phone: (401) 728-6811
Fax: (401) 728-6811

The enumeration date for this NPI number is 6/20/2006 and was last updated on 7/8/2007.

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
1163WD0400XRegistered NurseDiabetes EducatorRN29363RHODE ISLANDYes

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
121010-8OTHERRHODE ISLANDBLUE CROSS/BLUE SHIELD
228124OTHERRHODE ISLANDNEIGHBORHOOD HEALTH PLAN
363-00129OTHERRHODE ISLANDUNITED HEALTH CARE
4405279OTHERRHODE ISLANDBLUECHIP

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: 11/21/2025

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