Provider Demographics
NPI:1265820500
Name:BELL, JAMES MICHAEL (APRN)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MICHAEL
Last Name:BELL
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 HIGHWAY 62 W
Mailing Address - Street 2:
Mailing Address - City:ASH FLAT
Mailing Address - State:AR
Mailing Address - Zip Code:72513-9415
Mailing Address - Country:US
Mailing Address - Phone:870-994-2202
Mailing Address - Fax:870-994-2328
Practice Address - Street 1:308 HIGHWAY 62 W
Practice Address - Street 2:
Practice Address - City:ASH FLAT
Practice Address - State:AR
Practice Address - Zip Code:72513-9415
Practice Address - Country:US
Practice Address - Phone:870-994-2202
Practice Address - Fax:807-994-2328
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004268363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR308385758Medicaid
AR413251YJA8Medicare Oscar/Certification