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General NPI Number Information
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NPI Number | 1336146455
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Entity Type | Individual
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Provider Name | MARJORIE JEAN BELISLE APNP
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Gender | Female
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 2651 HILLCREST DRIVE SUITE 303
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City | HUDSON
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State | WI
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Zip | 54016-4439
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Country | US
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Telephone | 715-531-6800
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Fax | 715-531-6801
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Provider Business Mailing Address
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Address Line | 2651 HILLCREST DRIVE SUITE 303
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City | HUDSON
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State | WI
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Zip | 54016-4439
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Country | US
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Telephone | 715-531-6800
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Fax | 715-531-6801
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1973-033
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License Number State | WI
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