Provider Demographics
NPI:1619223740
Name:BELL, BRITNE LYNN (PA)
Entity Type:Individual
Prefix:
First Name:BRITNE
Middle Name:LYNN
Last Name:BELL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:BRITNE
Other - Middle Name:LYNN
Other - Last Name:WIMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:526 MOYE BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-2848
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:526 MOYE BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2848
Practice Address - Country:US
Practice Address - Phone:252-847-3898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10001426A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP01209632OtherRR MEDICARE PTAN
INP01209632OtherRR MEDICARE PTAN
IN068010014Medicare PIN