KRISTEN BOURGON MSN AGPCNP-BC NPI 1851838809

NPI Information

  • NPI: 1851838809
  • Provider Name: KRISTEN BOURGON, MSN, AGPCNP-BC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 21650 W 11 MILE RD STE 202
    SOUTHFIELD, MI
    ZIP 48076
  • Phone: (248) 327-6196

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NPI Details

Kristen Bourgon, MSN, AGPCNP-BC is a family nurse practitioner in Southfield, MI. Kristen Bourgon, MSN, AGPCNP-BC NPI is 1851838809. 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:

21650 W 11 MILE RD STE 202
SOUTHFIELD, MI
ZIP 48076-777
Phone: (248) 327-6196
Fax: (248) 327-6356

The NPI 1851838809 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 enumeration date for this NPI number is 1/30/2017 and was last updated on 3/9/2021.

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
1363LA2200XNurse PractitionerAdult Health4704277091MICHIGANNo
2363LF0000XNurse PractitionerFamily4704277091MICHIGANYes
3363LG0600XNurse PractitionerGerontology4704277091MICHIGANNo
4363LP2300XNurse PractitionerPrimary Care4704277091MICHIGANNo

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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