Provider Demographics
NPI:1518022110
Name:BELL, DIANE (RNC, ANP)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:RNC, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 ALGIRD ST.
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05408
Mailing Address - Country:US
Mailing Address - Phone:802-658-1952
Mailing Address - Fax:
Practice Address - Street 1:1 TIMBER LN
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7205
Practice Address - Country:US
Practice Address - Phone:802-847-4714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101-0015614363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1005734Medicaid
VTBENP1598Medicare ID - Type Unspecified
VT1005734Medicaid