Individual
KATHY J. BELLEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4062 W ROYAL DR, TRAVERSE CITY, MI 49684-8965
(231) 935-0338
Mailing address
4062 W ROYAL DR, TRAVERSE CITY, MI 49684-8965
(231) 935-0338
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704172326
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5008707120
BCBS PIN NUMBER
MI
Enumeration date
08/22/2007
Last updated
01/11/2008
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