Provider Demographics
NPI:1629525597
Name:BELL, DEVAUGHN (FNP-C)
Entity Type:Individual
Prefix:
First Name:DEVAUGHN
Middle Name:
Last Name:BELL
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1559
Mailing Address - Country:US
Mailing Address - Phone:661-635-3050
Mailing Address - Fax:661-324-6301
Practice Address - Street 1:815 DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307
Practice Address - Country:US
Practice Address - Phone:661-322-3905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95004580363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily