Provider Demographics
NPI:1982770442
Name:BLESSING, BEVERLY BELLE (FNP, PHD)
Entity Type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:BELLE
Last Name:BLESSING
Suffix:
Gender:F
Credentials:FNP, PHD
Other - Prefix:
Other - First Name:BEVERLY
Other - Middle Name:BELLE
Other - Last Name:BERNAL, MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:72780 COUNTRY CLUB DR
Mailing Address - Street 2:STE A103
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-4150
Mailing Address - Country:US
Mailing Address - Phone:760-775-2650
Mailing Address - Fax:760-347-9091
Practice Address - Street 1:72780 COUNTRY CLUB DR
Practice Address - Street 2:STE A103
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4150
Practice Address - Country:US
Practice Address - Phone:760-779-5511
Practice Address - Fax:760-773-3320
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13796363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily