Provider Demographics
NPI:1578780235
Name:BELMONTE, MICHELLE (NP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:BELMONTE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 MAGNOLIA AVE
Mailing Address - Street 2:MAIN APARTMENT
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939
Mailing Address - Country:US
Mailing Address - Phone:707-319-1399
Mailing Address - Fax:
Practice Address - Street 1:861 MAGNOLIA AVE
Practice Address - Street 2:MAIN APARTMENT
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1132
Practice Address - Country:US
Practice Address - Phone:707-319-1399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15087363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care