Provider Demographics
NPI:1598382384
Name:BELL, CRYSTAL COLLEEN (NP)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:COLLEEN
Last Name:BELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 LOCKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-7621
Mailing Address - Country:US
Mailing Address - Phone:401-602-0838
Mailing Address - Fax:
Practice Address - Street 1:170 LOCKWOOD ST
Practice Address - Street 2:
Practice Address - City:WEST WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02893-7621
Practice Address - Country:US
Practice Address - Phone:401-602-0838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN02370363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner