Healthcare Provider Details

I. General information

NPI: 1497035380
Provider Name (Legal Business Name): DENE RUTH BELLAMY CNS/PMH-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2011
Last Update Date: 08/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3073 PANTHERSVILLE ROAD
DECATUR GA
30034
US

IV. Provider business mailing address

4410 HOPKINS RUN DRIVE
DULUTH GA
30095-9531
US

V. Phone/Fax

Practice location:
  • Phone: 404-243-2281
  • Fax:
Mailing address:
  • Phone: 770-729-1608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN119661
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: