Provider Demographics
NPI:1649401464
Name:BELANGEE, KIMBERLY ANNE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANNE
Last Name:BELANGEE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 W ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:WAYNE CITY
Mailing Address - State:IL
Mailing Address - Zip Code:62895-9672
Mailing Address - Country:US
Mailing Address - Phone:618-895-2050
Mailing Address - Fax:618-895-2056
Practice Address - Street 1:1209 W ROBINSON ST
Practice Address - Street 2:
Practice Address - City:WAYNE CITY
Practice Address - State:IL
Practice Address - Zip Code:62895-9672
Practice Address - Country:US
Practice Address - Phone:618-895-2050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.007671207VX0000X
IL209007671363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily