Provider Demographics
NPI:1063107621
Name:BELMAN, KENLY LORRAINE
Entity type:Individual
Prefix:
First Name:KENLY
Middle Name:LORRAINE
Last Name:BELMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1985 EMANCIPATION HWY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-6233
Mailing Address - Country:US
Mailing Address - Phone:540-373-6647
Mailing Address - Fax:
Practice Address - Street 1:1985 EMANCIPATION HWY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-6233
Practice Address - Country:US
Practice Address - Phone:540-373-6647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant