Provider Demographics
NPI:1295394278
Name:BELL, DANIELLE (CPNP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3146 WOOD THRUSH DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-3177
Mailing Address - Country:US
Mailing Address - Phone:901-340-1515
Mailing Address - Fax:
Practice Address - Street 1:1444 E SHELBY DR STE 317
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-7257
Practice Address - Country:US
Practice Address - Phone:901-396-8281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25755363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty