Provider Demographics
NPI:1356961619
Name:BELLINGER, SUZANN (RN, BSN)
Entity type:Individual
Prefix:
First Name:SUZANN
Middle Name:
Last Name:BELLINGER
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 SHAFFER ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-1656
Mailing Address - Country:US
Mailing Address - Phone:269-250-9009
Mailing Address - Fax:
Practice Address - Street 1:1820 SHAFFER ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1656
Practice Address - Country:US
Practice Address - Phone:269-250-9009
Practice Address - Fax:269-381-6665
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704304282163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care