Provider Demographics
NPI:1689481996
Name:BELVILLEE, CARMEN (RN, CHPPN)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:BELVILLEE
Suffix:
Gender:F
Credentials:RN, CHPPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 87
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:MA
Mailing Address - Zip Code:01564-0087
Mailing Address - Country:US
Mailing Address - Phone:774-696-3663
Mailing Address - Fax:
Practice Address - Street 1:56 CHURCH ST APT 2
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-3148
Practice Address - Country:US
Practice Address - Phone:774-696-3663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2362374163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0200XNursing Service ProvidersRegistered NursePediatricsGroup - Single Specialty