Provider Demographics
NPI:1083812721
Name:BELL, NICHOLE RENEE (RN)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:RENEE
Last Name:BELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 LAKEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-9509
Mailing Address - Country:US
Mailing Address - Phone:906-249-2107
Mailing Address - Fax:
Practice Address - Street 1:369 LAKEWOOD LN
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-9509
Practice Address - Country:US
Practice Address - Phone:906-249-2107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704229119163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse