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General NPI Number Information
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NPI Number | 1962015958
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Entity Type | Individual
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Provider Name | EUN BELLISARIO CNP
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Gender | Female
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 6349 US HIGHWAY 550
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City | CUBA
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State | NM
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Zip | 87013-6032
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Country | US
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Telephone | 575-289-3291
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Fax | 505-443-8303
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Provider Business Mailing Address
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Address Line | 6349 US HIGHWAY 550
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City | CUBA
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State | NM
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Zip | 87013-6032
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Country | US
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Telephone | 575-289-3291
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Fax | 505-443-8303
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11008838
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 61906
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License Number State | NM
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