Provider Demographics
NPI:1639290687
Name:BELL, LINDA IRENE (CNM)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:IRENE
Last Name:BELL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1505 NORTHSIDE BLVD
Mailing Address - Street 2:SUITE 3500
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7623
Mailing Address - Country:US
Mailing Address - Phone:770-886-3555
Mailing Address - Fax:770-205-6501
Practice Address - Street 1:1505 NORTHSIDE BLVD
Practice Address - Street 2:SUITE 3500
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7623
Practice Address - Country:US
Practice Address - Phone:770-886-3555
Practice Address - Fax:770-205-6501
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN050794367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000423387CMedicaid