Provider Demographics
NPI:1417284472
Name:BELLER, NATALIE MARIE (RN)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:MARIE
Last Name:BELLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:MARIE
Other - Last Name:CONNELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1723 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-4420
Mailing Address - Country:US
Mailing Address - Phone:805-458-0220
Mailing Address - Fax:
Practice Address - Street 1:1288 MORRO ST STE 200
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-6302
Practice Address - Country:US
Practice Address - Phone:805-543-1233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA700117163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse