Provider Demographics
NPI:1275963282
Name:BELL, DEACQUELINE (CRNP)
Entity Type:Individual
Prefix:
First Name:DEACQUELINE
Middle Name:
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 1:8910 CROSSWIND CIRCLE APT. 201
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:334-239-7841
Practice Address - Street 1:1898 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1526
Practice Address - Country:US
Practice Address - Phone:334-239-7059
Practice Address - Fax:334-239-7841
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60696763363LF0000X
AL1-102645363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily