Doretha Bournes, NP
Nurse Practitioner, Family in Monticello, MS. Individual provider (NPI-1).
NPI number1487089546
StatusActive
Last updated in NPPESSep 9, 2013
Details
- NPI
- 1487089546
- Entity type
- Individual (NPI-1)
- Name
- Doretha Bournes
- Credential
- NP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 9, 2013
- Last updated
- Sep 9, 2013
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | R858932 | MS | Yes |
Practice location
354 Cub Brown RdMonticello, MS 39654-7505
Phone 601-587-4629
Mailing address
354 Cub Brown RdMonticello, MS 39654-7505
Phone 601-587-4629
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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