Provider Demographics
NPI:1619570421
Name:BELLAMY, CORTNEY
Entity Type:Individual
Prefix:
First Name:CORTNEY
Middle Name:
Last Name:BELLAMY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5004 N KENMORE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-2524
Mailing Address - Country:US
Mailing Address - Phone:317-796-2583
Mailing Address - Fax:
Practice Address - Street 1:5004 N KENMORE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-2524
Practice Address - Country:US
Practice Address - Phone:317-796-2583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator