Provider Demographics
NPI:1912710799
Name:BOURLIER, LINDA ROSE
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ROSE
Last Name:BOURLIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 NELSON AVE
Mailing Address - Street 2:
Mailing Address - City:GERING
Mailing Address - State:NE
Mailing Address - Zip Code:69341-1835
Mailing Address - Country:US
Mailing Address - Phone:308-641-5730
Mailing Address - Fax:
Practice Address - Street 1:1740 NELSON AVE
Practice Address - Street 2:
Practice Address - City:GERING
Practice Address - State:NE
Practice Address - Zip Code:69341-1835
Practice Address - Country:US
Practice Address - Phone:308-641-5730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician