Healthcare Provider Details

I. General information

NPI: 1649401464
Provider Name (Legal Business Name): KIMBERLY ANNE BELANGEE FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2009
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7386 FRIENDSHIP SPRINGS BLVD STE J
FLOWERY BRANCH GA
30542-5548
US

IV. Provider business mailing address

2501 CHATHAM RD STE N
SPRINGFIELD IL
62704-4188
US

V. Phone/Fax

Practice location:
  • Phone: 470-451-0646
  • Fax: 470-451-0647
Mailing address:
  • Phone: 618-599-3564
  • Fax: 618-731-4230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number27700024
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN323447
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: