Provider Demographics
NPI:1114430097
Name:BELL, RICHARD ANTHONY II (RN)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:ANTHONY
Last Name:BELL
Suffix:II
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:RICK
Other - Middle Name:
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7940 HANNAH RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30187-1237
Mailing Address - Country:US
Mailing Address - Phone:678-977-5946
Mailing Address - Fax:
Practice Address - Street 1:7940 HANNAH RD
Practice Address - Street 2:
Practice Address - City:WINSTON
Practice Address - State:GA
Practice Address - Zip Code:30187-1237
Practice Address - Country:US
Practice Address - Phone:678-977-5946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001275929163W00000X
DCRN1046485163W00000X
GARN258264163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
GADJI184A76603OtherBLUE CROSS BLUE SHIELD