Provider Demographics
NPI:1447875141
Name:BELLONE, CONSTANCE (RN, CCRN-K, CCHC)
Entity type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:
Last Name:BELLONE
Suffix:
Gender:F
Credentials:RN, CCRN-K, CCHC
Other - Prefix:MISS
Other - First Name:CONSTANCE
Other - Middle Name:ANN
Other - Last Name:SEGRAVE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, CCRN, CCHC
Mailing Address - Street 1:304 BLACK RIVER DR
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-9366
Mailing Address - Country:US
Mailing Address - Phone:504-650-1901
Mailing Address - Fax:
Practice Address - Street 1:304 BLACK RIVER DR
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70447-9366
Practice Address - Country:US
Practice Address - Phone:504-650-1901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN057903163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse