Provider Demographics
NPI:1538128640
Name:BELLS FAMILY MEDICINE
Entity Type:Organization
Organization Name:BELLS FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:JEANETTE
Authorized Official - Last Name:WALDROP
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:731-663-3794
Mailing Address - Street 1:103 FRONT STREET
Mailing Address - Street 2:
Mailing Address - City:BELLS
Mailing Address - State:TN
Mailing Address - Zip Code:38006
Mailing Address - Country:US
Mailing Address - Phone:731-663-3794
Mailing Address - Fax:731-663-3737
Practice Address - Street 1:103 FRONT ST
Practice Address - Street 2:
Practice Address - City:BELLS
Practice Address - State:TN
Practice Address - Zip Code:38006
Practice Address - Country:US
Practice Address - Phone:731-663-3794
Practice Address - Fax:731-663-3737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3902306Medicaid
TN4085780OtherBC/BS TENNCARE SELECT
TN0531133OtherUHAC
TN4085780OtherBC/BS OF TENNESSEE
TN32141OtherTLC -TN MANAGED CARE
TN3902306Medicaid
TN4085780OtherBC/BS TENNCARE SELECT