Provider Demographics
NPI:1528398658
Name:BELCOURT, JAIME R (RN)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:R
Last Name:BELCOURT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 W AVENUE B
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-3452
Mailing Address - Country:US
Mailing Address - Phone:406-788-3215
Mailing Address - Fax:
Practice Address - Street 1:716 W AVENUE B
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-3452
Practice Address - Country:US
Practice Address - Phone:406-788-3215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO174441163W00000X
MT30020163W00000X
NDR55077163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163W00000XNursing Service ProvidersRegistered Nurse