Kimberly C. Bourassa, DNP, APRN, PMHNP-BC
NPI 1104590660ActiveIndividual· Nurse Practitioner, Psych/Mental Health· Shakopee, MN
Nurse Practitioner, Psych/Mental Health (DNP, APRN, PMHNP-BC) with Fraser Child and Family Center, practicing in Shakopee, Minnesota. Part D covered 12 prescriptions written in 2024, 100% of them generic.
Overview
| NPI | 1104590660 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DNP, APRN, PMHNP-BC |
| Sole proprietor | No |
| NPI issued | Aug 6, 2021 |
| Last updated in NPPES | May 6, 2026 |
| Certified by provider | May 6, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Psych/Mental Health Primary | 363LP0808X | 9071 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (MN) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 12 · 12 30-day fills |
|---|---|
| Total drug cost | $183.72 |
| Generic share | 100% of claims |
Education and affiliations
| Graduation year | 2021 |
|---|---|
| Medicare specialty | Nurse Practitioner |
Medical group
- Fraser Child and Family CenterRichfield, MN · 53 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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