Provider Demographics
NPI:1225433352
Name:BELLIZZI, LORI BETH (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:BETH
Last Name:BELLIZZI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 S GREENE ST
Mailing Address - Street 2:THORACIC IMC
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1595
Mailing Address - Country:US
Mailing Address - Phone:551-265-7616
Mailing Address - Fax:
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:THORACIC IMC
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1595
Practice Address - Country:US
Practice Address - Phone:551-265-7616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-31
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014422363LA2100X
MDR227726363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care