Provider Demographics
NPI:1144624784
Name:BELIZAIRE, SABINE
Entity type:Individual
Prefix:MRS
First Name:SABINE
Middle Name:
Last Name:BELIZAIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12810 MAIDENWOOD TER
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-6337
Mailing Address - Country:US
Mailing Address - Phone:301-210-5419
Mailing Address - Fax:301-210-5419
Practice Address - Street 1:12810 MAIDENWOOD TER
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-6337
Practice Address - Country:US
Practice Address - Phone:301-210-5419
Practice Address - Fax:301-210-5419
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR148086163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD771093046OtherKAISER PERMANENTE