Provider Demographics
NPI:1376194043
Name:BELL, NIKITA DAWN
Entity Type:Individual
Prefix:
First Name:NIKITA
Middle Name:DAWN
Last Name:BELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:454 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:27525-9312
Mailing Address - Country:US
Mailing Address - Phone:410-652-9095
Mailing Address - Fax:
Practice Address - Street 1:454 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:NC
Practice Address - Zip Code:27525-9312
Practice Address - Country:US
Practice Address - Phone:410-652-9095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-24
Last Update Date:2019-12-02
Deactivation Date:2019-11-17
Deactivation Code:
Reactivation Date:2019-12-02
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant