Provider Demographics
NPI:1184860579
Name:BELL, BONNIE ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:ELIZABETH
Last Name:BELL
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 1:2217 PAPERMILL RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-1829
Mailing Address - Country:US
Mailing Address - Phone:540-773-4979
Mailing Address - Fax:304-263-6127
Practice Address - Street 1:2217 PAPERMILL RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2260
Practice Address - Country:US
Practice Address - Phone:540-773-4979
Practice Address - Fax:304-263-6127
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-06
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1744P3200X
1744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV6191780001Medicare NSC