Provider Demographics
NPI:1659038685
Name:BELL, NICOLE W
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:W
Last Name:BELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10950 JEFFERSON HWY APT J08
Mailing Address - Street 2:
Mailing Address - City:RIVER RIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70123-5713
Mailing Address - Country:US
Mailing Address - Phone:720-404-6551
Mailing Address - Fax:
Practice Address - Street 1:10950 JEFFERSON HWY APT J08
Practice Address - Street 2:
Practice Address - City:RIVER RIDGE
Practice Address - State:LA
Practice Address - Zip Code:70123-5713
Practice Address - Country:US
Practice Address - Phone:720-404-6551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator