Provider Demographics
NPI:1891960183
Name:BELLARD, NANCY K (LAC, A,P)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:K
Last Name:BELLARD
Suffix:
Gender:F
Credentials:LAC, A,P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SEAGROVE MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ST. AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-6088
Mailing Address - Country:US
Mailing Address - Phone:904-671-2860
Mailing Address - Fax:
Practice Address - Street 1:120 SEAGROVE MAIN STREET
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-6088
Practice Address - Country:US
Practice Address - Phone:904-671-2860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2088171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist