Provider Demographics
NPI:1528598786
Name:BELL, KATHY (RN IBCLC)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:RN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W ASPEN AVE
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-5305
Mailing Address - Country:US
Mailing Address - Phone:928-556-0000
Mailing Address - Fax:928-556-0001
Practice Address - Street 1:401 W ASPEN AVE
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-5305
Practice Address - Country:US
Practice Address - Phone:928-556-0000
Practice Address - Fax:928-556-0001
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000147239163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant