Provider Demographics
NPI:1326035890
Name:BELL, EVA MARIE (RN-BC, FNP, PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:EVA
Middle Name:MARIE
Last Name:BELL
Suffix:
Gender:F
Credentials:RN-BC, FNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-3764
Mailing Address - Country:US
Mailing Address - Phone:361-361-3360
Mailing Address - Fax:
Practice Address - Street 1:5414 KNIGHTS CIRCLE
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413
Practice Address - Country:US
Practice Address - Phone:361-361-3360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX571047363LF0000X, 363LP0808X
SC22962363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092901002Medicaid
TX82N273Medicare PIN
TX092901002Medicaid