Provider Demographics
NPI:1477985786
Name:BELL, CYNTHIA PRATHER (APRN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:PRATHER
Last Name:BELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 907
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:KY
Mailing Address - Zip Code:41339-0907
Mailing Address - Country:US
Mailing Address - Phone:606-666-5142
Mailing Address - Fax:606-666-4172
Practice Address - Street 1:832 HIGHWAY 15 N
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:KY
Practice Address - Zip Code:41339-8284
Practice Address - Country:US
Practice Address - Phone:606-666-5142
Practice Address - Fax:606-666-4172
Is Sole Proprietor?:No
Enumeration Date:2013-08-09
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008228363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100310960Medicaid
KYK099650Medicare PIN