Provider Demographics
NPI:1689040578
Name:BELLOMY, KATHERINE (CNM)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:BELLOMY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 N CLEVELAND AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8388
Mailing Address - Country:US
Mailing Address - Phone:614-818-0300
Mailing Address - Fax:614-818-0313
Practice Address - Street 1:444 N CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8388
Practice Address - Country:US
Practice Address - Phone:614-818-0300
Practice Address - Fax:614-818-0313
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNM.019434367A00000X, 367A00000X
OHAPRNCNM019434367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0403607Medicaid