Provider Demographics
NPI:1093166605
Name:BELLA, CHRISTELLE
Entity Type:Individual
Prefix:
First Name:CHRISTELLE
Middle Name:
Last Name:BELLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 PARK AVE APT 301
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-3542
Mailing Address - Country:US
Mailing Address - Phone:513-342-4297
Mailing Address - Fax:
Practice Address - Street 1:911 PARK AVE APT 301
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-3542
Practice Address - Country:US
Practice Address - Phone:513-342-4297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-24
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12113374U00000X
172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No374U00000XNursing Service Related ProvidersHome Health Aide