Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Miss. Kristen Bourque, RD, LD, CLC

Individual provider Registered Dietitian · NPI 1881083699

Miss. Kristen Bourque, RD, LD, CLC is a Registered Dietitian in Indianapolis, Indiana. Licensed in Illinois and Nevada. Registered with an NPI since 2015.

Licensed in
IL, NV
In the registry since
2015
Specialties on file
2
What do these letters mean?
RD — Registered Dietitian
A credentialed nutrition professional.
LD — Licensed Dietitian
A dietitian licensed by a state board.

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Practice location Address checks out

9115 Hague Rd
Indianapolis, IN 46256-1025
Phone: (317) 521-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 164.007743 (IL)
Registered Dietitian Taxonomy 133V00000X · Licence 32149DI-0 (NV)

Record details

NPI number1881083699
Entity typeIndividual (Type 1)
GenderFemale
Credentials RD , LD , CLC
Sole proprietorNo
NPI enumeratedJanuary 16, 2015
Last updated in NPPESDecember 15, 2021
Certification dateDecember 15, 2021

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