Provider Demographics
NPI:1437747672
Name:BELL, DANIEL MAXIMILLION (RN, CRNA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:MAXIMILLION
Last Name:BELL
Suffix:
Gender:M
Credentials:RN, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W 1050 S
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-6321
Mailing Address - Country:US
Mailing Address - Phone:707-592-1856
Mailing Address - Fax:
Practice Address - Street 1:150 W 1050 S
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-6321
Practice Address - Country:US
Practice Address - Phone:707-592-1856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95063097163W00000X
UT11222365-3102163W00000X
UT11222365-4406367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse