| Brenda Lynn Bourn, RD | |
|
1226 W River St, Boise, ID 83702-7049 | |
| (208) 331-1155 | |
| (208) 383-0190 |
| Full Name | Brenda Lynn Bourn |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 1226 W River St, Boise, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477728178 | NPI | - | NPPES |
| 1477728178 | Medicaid | ID |
| Provider Name | Dhhs Ihs Phoenix Area |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1396022026 PECOS PAC ID: 0244405629 Enrollment ID: O20120105000013 |
| Provider Name | Dhhs Ihs Phoenix Area |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1265719934 PECOS PAC ID: 7810163011 Enrollment ID: O20120109000961 |
| Provider Name | Irene Benn Medical Center |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1841535317 PECOS PAC ID: 0840430724 Enrollment ID: O20130717000832 |
| Mailing Address | Practice Location Address |
|---|---|
| Brenda Lynn Bourn, RD Po Box 95461, Cleveland, OH 44101-0033 Ph: (928) 669-3353 | Brenda Lynn Bourn, RD 1226 W River St, Boise, ID 83702-7049 Ph: (208) 331-1155 |
St Lukes Regional Medical Center Dietitian Medicare: Medicare Enrolled Practice Location: 1226 W River St, Boise, ID 83702 Phone: 208-331-1155 | |
Natalie Dawn Echanis, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 960 S Broadway Ave Ste 505, Boise, ID 83706 Phone: 208-780-6254 | |
Rachael Tatko, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 13900 W Wainwright Dr, Boise, ID 83713 Phone: 208-433-9424 | |
Ariana Lawrence, MS, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 305 E Jefferson St, Boise, ID 83712 Phone: 208-381-7081 Fax: 208-381-6009 | |
Daria T Pori, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 500 W Fort St, Boise, ID 83702 Phone: 208-422-1141 | |
Ms. Megan Marie Mcguffey, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1910 University Dr, Boise, ID 83725 Phone: 208-426-1459 | |
Rhonda L O'brien, MS, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1414 W Franklin St, Boise, ID 83702 Phone: 208-342-2228 Fax: 208-343-0889 |