Provider Demographics
NPI:1265638506
Name:BELL, DONELLA ROSETTA (LPN)
Entity Type:Individual
Prefix:MS
First Name:DONELLA
Middle Name:ROSETTA
Last Name:BELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16820 ARCHDALE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-3334
Mailing Address - Country:US
Mailing Address - Phone:313-541-2702
Mailing Address - Fax:
Practice Address - Street 1:16820 ARCHDALE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-3334
Practice Address - Country:US
Practice Address - Phone:313-541-2702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703057485164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse