Provider Demographics
NPI:1851973218
Name:BELLAMY, EVELYN MARIE
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:MARIE
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 1:1100 HARDEE RD STE 97B
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-2568
Mailing Address - Country:US
Mailing Address - Phone:252-361-2189
Mailing Address - Fax:252-523-2356
Practice Address - Street 1:1100 HARDEE RD STE 97B
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-2568
Practice Address - Country:US
Practice Address - Phone:252-361-2189
Practice Address - Fax:252-523-2356
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC5971253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care