Provider Demographics
NPI:1417820846
Name:BELLAFAIRE, ANN (LM, CPM)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:BELLAFAIRE
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 E SHARI ST
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-5950
Mailing Address - Country:US
Mailing Address - Phone:760-668-2338
Mailing Address - Fax:
Practice Address - Street 1:1123 E SHARI ST
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-5950
Practice Address - Country:US
Practice Address - Phone:760-668-2338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLM295176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife