Healthcare Provider Details

I. General information

NPI: 1720437056
Provider Name (Legal Business Name): RICCI CONTESSA BELISARIO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 08/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18077 RIVER RD
NOBLESVILLE IN
46062-8303
US

IV. Provider business mailing address

18077 RIVER RD
NOBLESVILLE IN
46062-8303
US

V. Phone/Fax

Practice location:
  • Phone: 317-214-6420
  • Fax: 317-214-6015
Mailing address:
  • Phone: 317-214-6420
  • Fax: 317-214-6015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71006303A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28171231A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: