Provider Demographics
NPI:1215385943
Name:BELL, KEVIN R (LPN)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:R
Last Name:BELL
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3406 REDWOOD FOREST LN
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-9074
Mailing Address - Country:US
Mailing Address - Phone:678-791-3433
Mailing Address - Fax:
Practice Address - Street 1:3406 REDWOOD FOREST LN
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-9074
Practice Address - Country:US
Practice Address - Phone:678-791-3433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN070640164W00000X
FLPN5159682164W00000X
TX329157164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse