Provider Demographics
NPI:1255085809
Name:BELLAMY, KIRA LYNN (CRNP)
Entity type:Individual
Prefix:
First Name:KIRA
Middle Name:LYNN
Last Name:BELLAMY
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 1:80 LANDINGS DR STE 205
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-9408
Mailing Address - Country:US
Mailing Address - Phone:724-941-3020
Mailing Address - Fax:724-426-7713
Practice Address - Street 1:80 LANDINGS DR STE 205
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-9408
Practice Address - Country:US
Practice Address - Phone:724-941-3020
Practice Address - Fax:724-426-7713
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025156363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner