Provider Demographics
NPI:1275088163
Name:BELL, MARTINE ELAINE (CRNP)
Entity Type:Individual
Prefix:
First Name:MARTINE
Middle Name:ELAINE
Last Name:BELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 MILFORD MILL RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-3328
Mailing Address - Country:US
Mailing Address - Phone:410-521-1555
Mailing Address - Fax:
Practice Address - Street 1:3630 MILFORD MILL RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-3328
Practice Address - Country:US
Practice Address - Phone:410-521-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-20
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR169762363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily