Provider Demographics
NPI:1578243291
Name:BELL, JOSALYN (LSA)
Entity Type:Individual
Prefix:
First Name:JOSALYN
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:LSA
Other - Prefix:
Other - First Name:JOSALYN
Other - Middle Name:
Other - Last Name:BUCHANAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSA
Mailing Address - Street 1:4624 LEE AVE # B
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-1425
Mailing Address - Country:US
Mailing Address - Phone:540-320-3866
Mailing Address - Fax:
Practice Address - Street 1:736 BATTLEFIELD BLVD N
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4941
Practice Address - Country:US
Practice Address - Phone:757-312-8121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0136000336246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant