Provider Demographics
NPI:1508232984
Name:BELL, JODI
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
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 1:31 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:AVONMORE
Mailing Address - State:PA
Mailing Address - Zip Code:15618-9753
Mailing Address - Country:US
Mailing Address - Phone:724-454-8674
Mailing Address - Fax:
Practice Address - Street 1:31 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:AVONMORE
Practice Address - State:PA
Practice Address - Zip Code:15618-9753
Practice Address - Country:US
Practice Address - Phone:724-454-8674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN268258164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse