Provider Demographics
NPI:1760376131
Name:MERCADO, BELLA M (PMHNP)
Entity type:Individual
Prefix:
First Name:BELLA
Middle Name:M
Last Name:MERCADO
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:BELLA
Other - Middle Name:M
Other - Last Name:MERCADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BSN
Mailing Address - Street 1:1310 7TH ST NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-1244
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1310 7TH ST NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-1244
Practice Address - Country:US
Practice Address - Phone:860-985-7023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0000000000000000363LP0808X
NM64000390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health