Provider Demographics
NPI:1336908920
Name:BELLAI, FATU
Entity Type:Individual
Prefix:MISS
First Name:FATU
Middle Name:
Last Name:BELLAI
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:FATU
Other - Middle Name:
Other - Last Name:BELLAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2615 51ST STREET
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310
Mailing Address - Country:US
Mailing Address - Phone:515-333-8147
Mailing Address - Fax:
Practice Address - Street 1:2615 51ST STREET
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310
Practice Address - Country:US
Practice Address - Phone:515-333-8147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide