Brenda Lynn Bourn, RD
NPI 1477728178ActiveIndividual· Dietitian, Registered· Boise, ID
Dietitian, Registered (RD) with Dhhs Ihs Phoenix Area and 1 other group, practicing in Boise, Idaho. Enrolled in Medicare as practitioner - registered dietitian or nutrition professional. Lists Parker Indian Health Center as a hospital affiliation.
Overview
| NPI | 1477728178 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | RD |
| Sole proprietor | No |
| NPI issued | Apr 24, 2008 |
| Last updated in NPPES | Aug 31, 2025 |
| Certified by provider | Aug 31, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | D-742 | ID |
| Dietitian, Registered | 133V00000X | 00864302 | AZ |
| Dietitian, Registered | 133V00000X | 00777 | NM |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Registered Dietitian Or Nutrition Professional (TX) |
|---|
Education and affiliations
| Graduation year | 2001 |
|---|---|
| Medicare specialty | Registered Dietitian Or Nutrition Professional |
Medical groups
- Dhhs Ihs Phoenix AreaSupai, AZ · 26 clinicians
- Irene Benn Medical CenterMoapa, NV · 5 clinicians
Hospital affiliation
- Parker Indian Health CenterParker, AZ
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All 148 registered dietitians in Boise · All registered dietitians in Idaho