Individual
JULIE K BELLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1600 PROVIDENCE DR, WACO, TX 76707-2261
(254) 313-4200
(254) 313-4326
Mailing address
1600 PROVIDENCE DR, WACO, TX 76707-2261
(254) 313-4200
(254) 313-4326
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
RN055170
AZ
363LP0200X
Pediatric Nurse Practitioner
Primary
2173
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00N59X
BCBS GRP #
TX
01
—
084249401
MEDICAID GRP # - STANDARD
TX
01
—
092245202
MEDICAID GRP # - THS
TX
05
—
120502
—
AZ
Enumeration date
07/03/2006
Last updated
11/16/2015
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