Provider Demographics
NPI:1801900535
Name:LA BELLA, JOSEPH PHILLP (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PHILLP
Last Name:LA BELLA
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:PHILLIP
Other - Last Name:LA BELLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 2006
Mailing Address - Street 2:217 GUADALUPE LANE
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87084-2006
Mailing Address - Country:US
Mailing Address - Phone:505-898-0689
Mailing Address - Fax:
Practice Address - Street 1:1501 SAN PEDRO DR SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-5153
Practice Address - Country:US
Practice Address - Phone:505-265-1711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR11597163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health