Healthcare Provider Details

I. General information

NPI: 1649974841
Provider Name (Legal Business Name): CHERYL DENISE BELLAMY DNP, APRN, CNM, CNS-
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W GRAND BLVD OFC I359
DETROIT MI
48202-2689
US

IV. Provider business mailing address

8700 LEROY
OAK PARK MI
48237
US

V. Phone/Fax

Practice location:
  • Phone: 313-510-9762
  • Fax:
Mailing address:
  • Phone: 313-510-9762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SW0102X
TaxonomyWomen's Health Clinical Nurse Specialist
License Number4704193611
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: