Provider Demographics
NPI:1578631792
Name:BELL, PAULINE (PAA)
Entity Type:Individual
Prefix:MRS
First Name:PAULINE
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:PAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 BARRETT LAKES BLVD NW
Mailing Address - Street 2:APT.1018
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-3196
Mailing Address - Country:US
Mailing Address - Phone:770-427-3429
Mailing Address - Fax:404-616-9213
Practice Address - Street 1:80 JESSE HILL JUNIOR DRIVE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303
Practice Address - Country:US
Practice Address - Phone:404-616-5519
Practice Address - Fax:404-616-9213
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002556367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant