Doreen Bezalem Fombin, PMHNP-C
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Bethel, AK
NPI 1881402147 · NPPES record last updated Apr 2, 2025
Key facts
- NPI
- 1881402147
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 5021489 (NC)
- Practice address
- PO Box 528
Bethel, AK 99559-0528 - Phone
- (907) 543-6000
- NPI assigned
- Dec 19, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5021489 | NC | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina Neuropsychiatry, P.a. | Past |
Accepting new patients | |
| North Carolina Neuropsychiatry, P.a. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 5021489 | NC | Yes |
Addresses
Primary practice location
PO Box 528
Bethel, AK 99559-0528
Mailing address
PO Box 528
Bethel, AK 99559-0528
Phone (907) 543-6000
Other providers in Bethel, AK
- Cynthia A Flores
- Lalena Jeanene Flores
- Hazel Flynn
- Larissa M Flynn
- Rose Flynn
- Ashley J Forbes
- Barbara Force
- Corbin John Ford
- William Chester Ford Jr.
- Brenda Fox
All providers in Bethel, AK · Psychiatric/Mental Health Nurse Practitioner in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.