Healthcare Provider Details

I. General information

NPI: 1629991849
Provider Name (Legal Business Name): ENDLESSWELL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 MILLCREEK DR
BRANDON MS
39047-9001
US

IV. Provider business mailing address

321 MILLCREEK DR
BRANDON MS
39047-9001
US

V. Phone/Fax

Practice location:
  • Phone: 601-572-1230
  • Fax:
Mailing address:
  • Phone: 601-572-1230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA RENEE BELLISARIO
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 601-572-1230