Provider Demographics
NPI:1538724273
Name:BELIARD, MIRLOURDES (CRNP)
Entity type:Individual
Prefix:
First Name:MIRLOURDES
Middle Name:
Last Name:BELIARD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27681 HARNESS LN
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-1737
Mailing Address - Country:US
Mailing Address - Phone:407-460-4235
Mailing Address - Fax:302-536-7627
Practice Address - Street 1:2425 N SALISBURY BLVD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-2138
Practice Address - Country:US
Practice Address - Phone:443-944-0196
Practice Address - Fax:443-944-0192
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR206424363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily