Provider Demographics
NPI:1386734093
Name:BOURGEOIS, PATRICIA YVONNE CYPRIEN (RNP)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:YVONNE CYPRIEN
Last Name:BOURGEOIS
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:110 WHITE OAK LN
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-2407
Mailing Address - Country:US
Mailing Address - Phone:501-257-1000
Mailing Address - Fax:501-257-3117
Practice Address - Street 1:2200 FORT ROOTS DR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-1709
Practice Address - Country:US
Practice Address - Phone:501-257-1000
Practice Address - Fax:501-257-3117
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARRNP P00498363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health