Provider Demographics
NPI:1700607181
Name:BELLAMY, LATOYA (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:LATOYA
Middle Name:
Last Name:BELLAMY
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 WATTS AVE
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23704-6448
Mailing Address - Country:US
Mailing Address - Phone:757-774-2509
Mailing Address - Fax:
Practice Address - Street 1:1501 WATTS AVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-6448
Practice Address - Country:US
Practice Address - Phone:757-774-2509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0732011024163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult