Provider Demographics
NPI:1326894460
Name:JESSUP, BELVIN J II (CH)
Entity type:Individual
Prefix:MR
First Name:BELVIN
Middle Name:J
Last Name:JESSUP
Suffix:II
Gender:M
Credentials:CH
Other - Prefix:MR
Other - First Name:BELVIN
Other - Middle Name:J
Other - Last Name:JESSUP
Other - Suffix:II
Other - Last Name Type:Professional Name
Other - Credentials:CH
Mailing Address - Street 1:312 ALOE RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-2108
Mailing Address - Country:US
Mailing Address - Phone:336-988-7416
Mailing Address - Fax:
Practice Address - Street 1:312 ALOE RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-2108
Practice Address - Country:US
Practice Address - Phone:336-988-7416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach