Provider Demographics
NPI:1649974841
Name:BELLAMY, CHERYL DENISE (DNP, APRN, CNM, CNS-)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:DENISE
Last Name:BELLAMY
Suffix:
Gender:F
Credentials:DNP, APRN, CNM, CNS-
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 LEROY
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237
Mailing Address - Country:US
Mailing Address - Phone:313-510-9762
Mailing Address - Fax:
Practice Address - Street 1:2799 W GRAND BLVD OFC I359
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2689
Practice Address - Country:US
Practice Address - Phone:313-510-9762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704193611364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's HealthGroup - Single Specialty