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General NPI Number Information
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NPI Number | 1437067295
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Entity Type | Individual
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Provider Name | TINA EILEEN BELISLE MSN
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Gender | Female
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 3841 BRICKWAY BLVD
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City | SANTA ROSA
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State | CA
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Zip | 95403-8226
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Country | US
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Telephone | 707-569-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 11820 RIVER RD SPC E4
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City | FORESTVILLE
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State | CA
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Zip | 95436-9826
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Country | US
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Telephone | 707-569-2300
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Fax |
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 14018685-3102
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 95474429
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License Number State | CA
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