Provider Demographics
NPI:1215170485
Name:BELLEZZA SENSA LLC
Entity type:Organization
Organization Name:BELLEZZA SENSA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:WHNP-BC, MS
Authorized Official - Phone:928-237-4422
Mailing Address - Street 1:990 COUNTRY PARK DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-4058
Mailing Address - Country:US
Mailing Address - Phone:928-237-4422
Mailing Address - Fax:928-237-4421
Practice Address - Street 1:6000 WILLOW CREEK RD # 304
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-6189
Practice Address - Country:US
Practice Address - Phone:928-237-4422
Practice Address - Fax:928-237-4421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAPO-197363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty