Provider Demographics
NPI:1588690697
Name:BELLAMY, KENDRA ALLEN (FNP)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:ALLEN
Last Name:BELLAMY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 20TH ST STE 505
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-1869
Mailing Address - Country:US
Mailing Address - Phone:865-546-0157
Mailing Address - Fax:
Practice Address - Street 1:501 20TH ST STE 505
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-1869
Practice Address - Country:US
Practice Address - Phone:865-546-0157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000008266363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3929290Medicaid
TNP84843Medicare UPIN