NPI 1194070466 · live from the CMS NPI Registry
Andrea Bourke, RPA-C
Physician Assistant, Medical in Londonderry, NH. National Provider Identifier 1194070466, active.
NPI record
| NPI | 1194070466 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 1c Commons Dr Unit 16, Londonderry, NH 03053 |
| Practice phone | 603-965-3551 |
| Mailing address | 784 Central Ave, Dover, NH 03820 |
| Enumerated | July 23, 2012 |
| Last updated | September 12, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Medical | 363AM0700X | 015768 (NY) |
| Physician Assistant, Medical primary | 363AM0700X | 5643 (CT) |
| Physician Assistant, Medical | 363AM0700X | 1660 (NH) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.