Provider Demographics
NPI:1861770653
Name:BELLEVUE, MARIE
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:BELLEVUE
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 1:606 WHALERS DR
Mailing Address - Street 2:
Mailing Address - City:ABSECON
Mailing Address - State:NJ
Mailing Address - Zip Code:08201-2833
Mailing Address - Country:US
Mailing Address - Phone:973-444-4954
Mailing Address - Fax:
Practice Address - Street 1:606 WHALERS DR
Practice Address - Street 2:
Practice Address - City:ABSECON
Practice Address - State:NJ
Practice Address - Zip Code:08201-2833
Practice Address - Country:US
Practice Address - Phone:973-444-4954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304804164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse