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NPI Code Detail

MEDICARE: BELLA-ROUGE HEALTH CARE INC

MEDICARE: BELLA-ROUGE HEALTH CARE INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner
2261QH0100XHealth Service Clinic/Center

General Provider Information

NPI Number : 1104439835
Entity Type Code : Organization
Provider Name (Legal Business Name) : BELLA-ROUGE HEALTH CARE INC
Provider Business Mailing Address
First Line : PO BOX 70
Second Line :
City : NATCHEZ
State : MS
Zip : 39121-0070
Country : US
Telephone Number : 225-433-3172
Fax Number : 601-228-4471
Provider Business Practice Location Address
First Line : 4510 OFFICE PARK DR
Second Line :
City : JACKSON
State : MS
Zip : 39206-6016
Country : US
Telephone Number : 225-433-3172
Fax Number : 601-228-4471
Authorized Official
Title or Position : DNP
Name : BLANCHE MAE BELL
Credential : NURSE PRACTITIONER
Telephone Number : 305-978-4907
Provider Enumeration Date : 08/24/2020
Last Update Date : 06/12/2023

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Directions to “BELLA-ROUGE HEALTH CARE INC ” Practice Location

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