Provider Demographics
NPI:1003870635
Name:BELL, BRENDA KAY (MD)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:KAY
Last Name:BELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:KAY
Other - Last Name:TROUTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1919 S 40TH
Mailing Address - Street 2:STE 207
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506
Mailing Address - Country:US
Mailing Address - Phone:402-489-3383
Mailing Address - Fax:402-489-3789
Practice Address - Street 1:1919 S 40TH
Practice Address - Street 2:STE 207
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506
Practice Address - Country:US
Practice Address - Phone:402-489-3383
Practice Address - Fax:402-489-3789
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20639207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47084339200Medicaid
NE47084339200Medicaid
274626Medicare ID - Type Unspecified