Provider Demographics
NPI:1770902124
Name:BELLINGER, NANCY (NP)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:BELLINGER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6031 FAIRBURN RD
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-2307
Mailing Address - Country:US
Mailing Address - Phone:770-942-9214
Mailing Address - Fax:
Practice Address - Street 1:360 RACETRACK RD
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-1022
Practice Address - Country:US
Practice Address - Phone:470-557-4399
Practice Address - Fax:478-910-1053
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA850946163W00000X
CA254771164X00000X
GARN238548363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse