person
Mrs. Lydia Cornell Bourke, NP
Adult Health Nurse Practitioner in Rochester Hills, Michigan
NPI 1578688560

Lydia Cornell Bourke is an Adult Health Nurse Practitioner based in Grosse Pointe, MI and is specialized in Adult Health. Lydia Cornell Bourke practices in Rochester Hills, MI and has the professional credentials of NP. The NPI Number for Lydia Cornell Bourke is 1578688560 and holds a License No. 4704215985 (Michigan).

The current practice location address for Lydia Cornell Bourke is 2494 S Rochester Rd, Rochester Hills, MI and can be reached out via phone at 248-299-9850 and via fax at 248-299-9860. You can also correspond with Lydia Cornell Bourke through the mailing address at 472 LINCOLN RD, GROSSE POINTE, MI - 48230-1609 (mailing address contact number: 248-299-9850).

Location: 2494 S Rochester Rd, Rochester Hills, MI, 48230-1609
person
Provider Profile Details
NPI Number
1578688560
Provider Name
Lydia Cornell Bourke
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
2494 S Rochester Rd, Rochester Hills, MI, 48230-1609
Phone Number
248-299-9850
Fax Number
248-299-9860
Provider Enumeration Date
03/20/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5008670700 01 MI BCBS INDIVIDUAL #
4704215985 01 MI NURSE LICENSE
5187136 10 05 MI
4704215985 01 MI NURSE PRACTITIONER LICEN
institution
Provider Business Practice Location Address Details
Address
2494 S Rochester Rd
City
State
Zip
48307-3817
Phone Number
248-299-9850
Fax Number
248-299-9860
person
Provider Business Mailing Address Details
Address
2494 S Rochester Rd
City
State
Zip
48307-3817
Phone Number
248-299-9850
Fax Number
248-299-9860
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Medical-Surgical
Taxonomy
License No.
4704215985 (Michigan)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
License No.
4704215985 (Michigan)
Definition
Definition to come...
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