Provider Demographics
NPI:1790247633
Name:BELL, ROBERT ANDREW (FNP)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ANDREW
Last Name:BELL
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HARRIS INDUSTRIAL BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30474-8852
Mailing Address - Country:US
Mailing Address - Phone:912-535-3500
Mailing Address - Fax:912-535-4498
Practice Address - Street 1:1006 MOUNT VERNON RD
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:GA
Practice Address - Zip Code:30474-3029
Practice Address - Country:US
Practice Address - Phone:912-537-1221
Practice Address - Fax:912-537-1012
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN222714363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily