Provider Demographics
NPI:1558050963
Name:BELCHER, CAROLL (BSN RN)
Entity Type:Individual
Prefix:MRS
First Name:CAROLL
Middle Name:
Last Name:BELCHER
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 WELLINGTON CT
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1478
Mailing Address - Country:US
Mailing Address - Phone:732-966-6610
Mailing Address - Fax:
Practice Address - Street 1:13 WELLINGTON CT
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-1478
Practice Address - Country:US
Practice Address - Phone:732-966-6610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO12186600163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management