Healthcare Provider Details

I. General information

NPI: 1063346187
Provider Name (Legal Business Name): CHRISTINA RENEE BELLISARIO PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 N FLOWOOD DR STE C2
FLOWOOD MS
39232-9738
US

IV. Provider business mailing address

1050 N FLOWOOD DR STE C2
FLOWOOD MS
39232-9738
US

V. Phone/Fax

Practice location:
  • Phone: 601-685-3682
  • Fax: 601-265-6239
Mailing address:
  • Phone: 601-685-3682
  • Fax: 601-265-6239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number908644
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: